XpanDH Hospital Discharge Report
0.1.0 - ci-build 150

XpanDH Hospital Discharge Report, published by XpanDH Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/xpandh-hdr/ and changes regularly. See the Directory of published versions

## Resource Profile: Xpandh Immunization Profile

Official URL: http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/immunization-xpandh | Version: 0.1.0
Draft as of 2025-10-10 | Computable Name: ImmunizationXpandh
Copyright/Legal: Used by permission of the XpanDH project, all rights reserved Creative Commons License

This profile sets minimum expectations for the Immunization resource to record, search, and fetch immunization details. It is based on the Immunization profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets which SHALL be present in the Immunization resource when using this profile.

Usages:

- Refer to this Profile: Composition: Hospital Discharge Report

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
vaccineCode | Σ | 1..1 | CodeableConceptIPS | Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | candidate | For when WHO ATC code system is preferred
patient | Σ | 1..1 | Reference(Patient: HDR) | Who was immunized
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
occurrence[x] | Σ | 1..1 |  | Vaccine administration date
occurrence[x]All Types |  |  |  | Content/Rules for all Types
Slices for extension |  |  |  | Content/Rules for all slices
extension:data-absent-reason |  | 0..1 | code | occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
occurrenceDateTime |  |  | dateTime |
occurrenceString |  |  | string |
site |  | 0..1 | CodeableConceptIPS | Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route |  | 0..1 | CodeableConceptIPS | How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.site | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Immunization.route | Base | preferred | Medicine Route of Administration - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Immunization | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Immunization | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Immunization | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Immunization | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Immunization | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from Immunization

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization Profile
vaccineCode |  | 1..1 | CodeableConceptIPS | Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | candidate | For when WHO ATC code system is preferred
patient |  | 1..1 | Reference(Patient: HDR) | Who was immunized
reference |  | 1..1 | string | Literal reference, Relative, internal or absolute URL
occurrence[x] |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:data-absent-reason |  | 0..1 | code | occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
site |  | 0..1 | CodeableConceptIPS | Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route |  | 0..1 | CodeableConceptIPS | How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
performer |  |  |  |
actor |  | 1..1 | Reference(Practitioner | PractitionerRole | Xpandh Organization Profile) | Individual or organization who was performing
protocolApplied |  |  |  |
targetDisease |  | 0..* | CodeableConcept | Vaccine preventable disease being targeted Binding: Xpandh Immunization Target Disease or Agent (preferred): The particular disease or diseases against which the patient has been immunized.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.site | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Immunization.route | Base | preferred | Medicine Route of Administration - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.protocolApplied.​targetDisease | Base | preferred | Xpandh Immunization Target Disease or Agent | 📦0.1.0 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business identifier
status | ?!Σ | 1..1 | code | completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason |  | 0..1 | CodeableConcept | Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | Σ | 1..1 | CodeableConceptIPS | Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | candidate | For when WHO ATC code system is preferred
patient | Σ | 1..1 | Reference(Patient: HDR) | Who was immunized
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
encounter |  | 0..1 | Reference(Encounter) | Encounter immunization was part of
occurrence[x] | Σ | 1..1 |  | Vaccine administration date
occurrence[x]All Types |  |  |  | Content/Rules for all Types
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:data-absent-reason |  | 0..1 | code | occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
occurrenceDateTime |  |  | dateTime |
occurrenceString |  |  | string |
recorded |  | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | Σ | 0..1 | boolean | Indicates context the data was recorded in
reportOrigin |  | 0..1 | CodeableConcept | Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
location |  | 0..1 | Reference(Location) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer
lotNumber |  | 0..1 | string | Vaccine lot number
expirationDate |  | 0..1 | date | Vaccine expiration date
site |  | 0..1 | CodeableConceptIPS | Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route |  | 0..1 | CodeableConceptIPS | How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
doseQuantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of vaccine administered
performer | Σ | 0..* | BackboneElement | Who performed event
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Xpandh Organization Profile) | Individual or organization who was performing
note | Σ | 0..* | Annotation | Additional immunization notes
reasonCode |  | 0..* | CodeableConcept | Why immunization occurred Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Why immunization occurred
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
subpotentReason |  | 0..* | CodeableConcept | Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
education | C | 0..* | BackboneElement | Educational material presented to patient Constraints: imm-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
documentType |  | 0..1 | string | Educational material document identifier
reference |  | 0..1 | uri | Educational material reference pointer
publicationDate |  | 0..1 | dateTime | Educational material publication date
presentationDate |  | 0..1 | dateTime | Educational material presentation date
programEligibility |  | 0..* | CodeableConcept | Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
fundingSource |  | 0..1 | CodeableConcept | Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
reaction |  | 0..* | BackboneElement | Details of a reaction that follows immunization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
date |  | 0..1 | dateTime | When reaction started
detail |  | 0..1 | Reference(Observation) | Additional information on reaction
reported |  | 0..1 | boolean | Indicates self-reported reaction
protocolApplied |  | 0..* | BackboneElement | Protocol followed by the provider
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
series |  | 0..1 | string | Name of vaccine series
authority |  | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations
targetDisease |  | 0..* | CodeableConcept | Vaccine preventable disease being targeted Binding: Xpandh Immunization Target Disease or Agent (preferred): The particular disease or diseases against which the patient has been immunized.
doseNumber[x] |  | 1..1 |  | Dose number within series
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
seriesDoses[x] |  | 0..1 |  | Recommended number of doses for immunity
seriesDosesPositiveInt |  |  | positiveInt |
seriesDosesString |  |  | string |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.patient.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Immunization.reportOrigin | Base | example | Immunization Origin Codes | 📍4.0.1 | FHIR Std.
Immunization.site | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Immunization.route | Base | preferred | Medicine Route of Administration - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.performer.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.reasonCode | Base | example | Immunization Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.subpotentReason | Base | example | Immunization Subpotent Reason | 📍4.0.1 | FHIR Std.
Immunization.programEligibility | Base | example | Immunization Program Eligibility | 📍4.0.1 | FHIR Std.
Immunization.fundingSource | Base | example | Immunization Funding Source | 📍4.0.1 | FHIR Std.
Immunization.protocolApplied.​targetDisease | Base | preferred | Xpandh Immunization Target Disease or Agent | 📦0.1.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Immunization | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Immunization | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Immunization | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Immunization | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Immunization | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
imm-1 | error | Immunization.education | One of documentType or reference SHALL be present | `documentType.exists() or reference.exists()`

This structure is derived from Immunization

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Patient: HDR (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Patient-eu-xpandh)
- Practitioner (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Practitioner-eu-xpandh)
- PractitionerRole (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/PractitionerRole-eu-xpandh)
- Xpandh Organization Profile (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/organization-expandh)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/data-absent-reason

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
vaccineCode | Σ | 1..1 | CodeableConceptIPS | Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | candidate | For when WHO ATC code system is preferred
patient | Σ | 1..1 | Reference(Patient: HDR) | Who was immunized
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
occurrence[x] | Σ | 1..1 |  | Vaccine administration date
occurrence[x]All Types |  |  |  | Content/Rules for all Types
Slices for extension |  |  |  | Content/Rules for all slices
extension:data-absent-reason |  | 0..1 | code | occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
occurrenceDateTime |  |  | dateTime |
occurrenceString |  |  | string |
site |  | 0..1 | CodeableConceptIPS | Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route |  | 0..1 | CodeableConceptIPS | How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.site | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Immunization.route | Base | preferred | Medicine Route of Administration - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Immunization | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Immunization | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Immunization | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Immunization | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Immunization | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from Immunization

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization Profile
vaccineCode |  | 1..1 | CodeableConceptIPS | Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | candidate | For when WHO ATC code system is preferred
patient |  | 1..1 | Reference(Patient: HDR) | Who was immunized
reference |  | 1..1 | string | Literal reference, Relative, internal or absolute URL
occurrence[x] |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:data-absent-reason |  | 0..1 | code | occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
site |  | 0..1 | CodeableConceptIPS | Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route |  | 0..1 | CodeableConceptIPS | How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
performer |  |  |  |
actor |  | 1..1 | Reference(Practitioner | PractitionerRole | Xpandh Organization Profile) | Individual or organization who was performing
protocolApplied |  |  |  |
targetDisease |  | 0..* | CodeableConcept | Vaccine preventable disease being targeted Binding: Xpandh Immunization Target Disease or Agent (preferred): The particular disease or diseases against which the patient has been immunized.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.site | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Immunization.route | Base | preferred | Medicine Route of Administration - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.protocolApplied.​targetDisease | Base | preferred | Xpandh Immunization Target Disease or Agent | 📦0.1.0 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business identifier
status | ?!Σ | 1..1 | code | completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason |  | 0..1 | CodeableConcept | Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | Σ | 1..1 | CodeableConceptIPS | Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | candidate | For when WHO ATC code system is preferred
patient | Σ | 1..1 | Reference(Patient: HDR) | Who was immunized
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
encounter |  | 0..1 | Reference(Encounter) | Encounter immunization was part of
occurrence[x] | Σ | 1..1 |  | Vaccine administration date
occurrence[x]All Types |  |  |  | Content/Rules for all Types
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:data-absent-reason |  | 0..1 | code | occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
occurrenceDateTime |  |  | dateTime |
occurrenceString |  |  | string |
recorded |  | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | Σ | 0..1 | boolean | Indicates context the data was recorded in
reportOrigin |  | 0..1 | CodeableConcept | Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
location |  | 0..1 | Reference(Location) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer
lotNumber |  | 0..1 | string | Vaccine lot number
expirationDate |  | 0..1 | date | Vaccine expiration date
site |  | 0..1 | CodeableConceptIPS | Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route |  | 0..1 | CodeableConceptIPS | How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
doseQuantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of vaccine administered
performer | Σ | 0..* | BackboneElement | Who performed event
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Xpandh Organization Profile) | Individual or organization who was performing
note | Σ | 0..* | Annotation | Additional immunization notes
reasonCode |  | 0..* | CodeableConcept | Why immunization occurred Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Why immunization occurred
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
subpotentReason |  | 0..* | CodeableConcept | Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
education | C | 0..* | BackboneElement | Educational material presented to patient Constraints: imm-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
documentType |  | 0..1 | string | Educational material document identifier
reference |  | 0..1 | uri | Educational material reference pointer
publicationDate |  | 0..1 | dateTime | Educational material publication date
presentationDate |  | 0..1 | dateTime | Educational material presentation date
programEligibility |  | 0..* | CodeableConcept | Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
fundingSource |  | 0..1 | CodeableConcept | Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
reaction |  | 0..* | BackboneElement | Details of a reaction that follows immunization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
date |  | 0..1 | dateTime | When reaction started
detail |  | 0..1 | Reference(Observation) | Additional information on reaction
reported |  | 0..1 | boolean | Indicates self-reported reaction
protocolApplied |  | 0..* | BackboneElement | Protocol followed by the provider
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
series |  | 0..1 | string | Name of vaccine series
authority |  | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations
targetDisease |  | 0..* | CodeableConcept | Vaccine preventable disease being targeted Binding: Xpandh Immunization Target Disease or Agent (preferred): The particular disease or diseases against which the patient has been immunized.
doseNumber[x] |  | 1..1 |  | Dose number within series
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
seriesDoses[x] |  | 0..1 |  | Recommended number of doses for immunity
seriesDosesPositiveInt |  |  | positiveInt |
seriesDosesString |  |  | string |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.patient.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Immunization.reportOrigin | Base | example | Immunization Origin Codes | 📍4.0.1 | FHIR Std.
Immunization.site | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.
Immunization.route | Base | preferred | Medicine Route of Administration - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
Immunization.performer.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.reasonCode | Base | example | Immunization Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.subpotentReason | Base | example | Immunization Subpotent Reason | 📍4.0.1 | FHIR Std.
Immunization.programEligibility | Base | example | Immunization Program Eligibility | 📍4.0.1 | FHIR Std.
Immunization.fundingSource | Base | example | Immunization Funding Source | 📍4.0.1 | FHIR Std.
Immunization.protocolApplied.​targetDisease | Base | preferred | Xpandh Immunization Target Disease or Agent | 📦0.1.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Immunization | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Immunization | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Immunization | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Immunization | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Immunization | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
imm-1 | error | Immunization.education | One of documentType or reference SHALL be present | `documentType.exists() or reference.exists()`

This structure is derived from Immunization

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Patient: HDR (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Patient-eu-xpandh)
- Practitioner (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Practitioner-eu-xpandh)
- PractitionerRole (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/PractitionerRole-eu-xpandh)
- Xpandh Organization Profile (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/organization-expandh)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/data-absent-reason

Other representations of profile: CSV, Excel, Schematron