Scope and Usage

The ImmunizationRecommendation resource is defined to use in a recommendation response from a clinical decision support system (CDS).

For more information look at the description about CDS for immunization recommendation.

Description out of FHIR R6 ballot

Scope and Usage

The ImmunizationRecommendation resource is intended to cover the expression of a customized set of immunization recommendations and status for a specific individual with the ultimate goal of achieving long-lasting immunity in the individual. This can include recommending future doses to progress the individual along the path to immunity and/or indicating that vaccination is not needed (e.g., the individual has completed the recommended set of doses and has presumed immunity, a contraindication or other condition would render further doses inadvisable, an acquired immunity negates the need for additional doses, the patient has aged out of a series). Where the individual is not yet fully protected, recommendations may be used to initiate clinical activity such as the ordering and administration of a vaccine. These recommendations may be used for non-clinical purposes such as presentation of vaccination credentials, satisfaction of school enrollment requirements or public health purposes. While not explicitly expressed in the resource itself, the "intent" of an ImmunizationRecommendation resource is always considered to be "proposal".

An ImmunizationRecommendation is a point-in-time representation of an individual's data compared against a set of guidelines designed by healthcare professionals to protect individuals against a wide range of vaccine preventable diseases. These sets of guidelines go by various names in different locales, but for the sake of what follows, they will be referred to as a "schedule". Schedules are often age-based but can also contain recommendations based on other information about the patient including things like allergies, underlying medical conditions, prescribed medications, personal behaviors and other attributes. For example, in the United States, all infants are recommended to receive their first dose of the polio vaccine by 2 months of age while healthcare professionals are recommended to be vaccinated against Hepatitis B if they are routinely exposed to blood products. Documented within the schedule for a given vaccine preventable disease, one or more “series” may be defined. A series is a set of one or more recommended vaccinations that is intended to produce immunity in the vaccinated individual. Examples of series include the standard 2-dose MMR series to protect against measles, mumps and rubella or the 3-dose HepA/HepB series to protect against Hepatitis A and B. An individualized immunization recommendation is typically the product of a clinical decision support (CDS) engine which takes the individual's data and a machine computable schedule as inputs to evaluate the patient's current immunization status and forecast future needs. Note that an immunization recommendation may also indicate that further vaccination is not required for a given target disease if the individual has completed their path to immunity. A comparison of the individual's data against different guidelines may result in a different set of recommendations. Also note that schedules themselves may evolve over time potentially resulting in new recommendations for a given individual. As noted in the figure below, a set of individualized immunization recommendations may then be used for a variety of purposes. Perhaps the most obvious usage is as the basis for a healthcare provider to develop and implement a plan to vaccinate the individual. However, other usages are possible including as a basis for vaccine credentialling, meeting school admission requirements, and performing public health activities. Because the recommendations for an individual can change over time, the data contained in an ImmunizationRecommendation resource is expected to be the basis for clinical action for only a short period of time.

An individual recommendation in the ImmunizationRecommendation resource will often relate to the recommendation of a specific dose of vaccine. The base ImmunizationRecommendation is silent on the time frame for the recommended administration date for a recommendation contained in the resource. That is, it is a system decision about how far in advance (1 day, 1 week, 6 weeks, 6 months, etc) of the recommendation administration date a recommendation is made. A recommendation may also be used to indicate that additional doses are not needed for some reason (such as the series is complete, the patient has aged out of the series, the patient is immune through some other mechanism or additional doses are contraindicated). This functionality may be important to convey to end users that they should not take action.

The display of immunization recommendations to end users is the responsibility of the system using the data contained in the ImmunizationRecommendation resource. Use case specific Implementation Guides can define specific display or usage expectations (if any) of systems using the recommendations contained in the resource.

Boundaries and Relationships

As noted above, the comparison of an individual's data against a schedule includes an evaluation of each prior dose of vaccine against the guidelines set forth in the schedule. The outcome of this evaluation is either the validation of the prior dose (that is, the dose is "valid" and advances the individual on the path to immunity) or the determination that the prior dose was "invalid" for some reason and cannot count towards meeting the guidelines in the schedule. The evaluation outcome for a given dose of vaccine can be expressed in the ImmunizationEvaluation resource.

An ImmunizationRecommendation resource may reference the relevant Immunization and ImmunizationEvaluation resources that underly the recommendation. Additional resources may be referenced where they document other factors (such as underlying medical conditions, behaviors, etc) which impact the recommendation.

The recommendations contained within an ImmunizationRecommendation resource may be used to initiate a set of clinical activities leading to the administration and documentation of one or more doses of vaccine. Where a record of an order to administer a vaccine is required, the MedicationRequest resource is used. The value of MedicationRequest.intent is used to distinguish between a plan to vaccinate and an authorized order. MedicationRequest.basedOn may be used to link the order to the initiating ImmunizationRecommendation. The documentation of the administration of the vaccine should be accomplished through the use of the Immunization resource.

Note that the ImmunizationRecommendation resource allows the inclusion of multiple recommendations in a single instance of the resource. Where the output of the evaluation process results in only a single recommendation, the use of MedicationRequest where .intent is valued "proposal" is allowed as an alternative to the ImmunizationRecommendation resource if it simplifies the subsequent clinical workflow.

Fig.: Immunization Recommendation

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	CHCoreImmunizationRecommendation	CH VACD Immunization Recommendation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..1	Resource	ImmunizationRecommendation inline resource
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
patient	Σ	1..1	Reference(CH Core Patient)	Patient
date	Σ	1..1	dateTime	Date recommendation(s) created
recommendation	ΣC	1..*	BackboneElement	Vaccine administration recommendations Constraints: imr-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
vaccineCode	Σ	0..*	CodeableConcept	Immunization Recommendation Vaccine Code Binding: CH VACD Swiss Vaccination Plan Immunizations (extensible)
targetDisease	SΣ	1..1	CodeableConcept	Disease to be immunized against Binding: CH VACD Target disease and illnesses undergone for immunization (extensible)
forecastStatus	?!Σ	1..1	CodeableConcept	Vaccine recommendation status Binding: CH VACD Swiss Recommendation Forecast Status (preferred): The reason the forecast is done.
forecastReason	SΣ	1..*	CodeableConcept	Vaccine administration status reason Binding: CH VACD Recommendation Categories for Immunizations (extensible)
dateCriterion	S	1..*	BackboneElement	Dates governing proposed immunization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Type of date Binding: ImmunizationRecommendationDateCriterionCodes (example): Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.).
value		1..1	dateTime	Recommended date
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	CH VACD Swiss Vaccination Plan Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	CH VACD Target disease and illnesses undergone for immunization	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	CH VACD Swiss Recommendation Forecast Status	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.forecastReason	Base	extensible	CH VACD Recommendation Categories for Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.dateCriterion.​code	Base	example	Immunization Recommendation Date Criterion Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ImmunizationRecommendation	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	ImmunizationRecommendation	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	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ImmunizationRecommendation	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()
imr-1	error	ImmunizationRecommendation.recommendation	One of vaccineCode or targetDisease SHALL be present	vaccineCode.exists() or targetDisease.exists()

This structure is derived from CHCoreImmunizationRecommendation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	CHCoreImmunizationRecommendation	CH VACD Immunization Recommendation
contained		0..1	Resource	ImmunizationRecommendation inline resource
recommendation
vaccineCode		0..*	CodeableConcept	Immunization Recommendation Vaccine Code Binding: CH VACD Swiss Vaccination Plan Immunizations (extensible)
targetDisease	S	1..1	CodeableConcept	Disease to be immunized against Binding: CH VACD Target disease and illnesses undergone for immunization (extensible)
forecastReason	S	1..*	CodeableConcept	Vaccine administration status reason Binding: CH VACD Recommendation Categories for Immunizations (extensible)
dateCriterion	S	1..*	BackboneElement	Dates governing proposed immunization
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	CH VACD Swiss Vaccination Plan Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	CH VACD Target disease and illnesses undergone for immunization	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.forecastReason	Base	extensible	CH VACD Recommendation Categories for Immunizations	📦3.3.0-ci-build	CH Term v3.3

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	CHCoreImmunizationRecommendation	CH VACD Immunization Recommendation
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..1	Resource	ImmunizationRecommendation inline resource
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier
patient	Σ	1..1	Reference(CH Core Patient)	Patient
date	Σ	1..1	dateTime	Date recommendation(s) created
authority		0..1	Reference(CH Core Organization)	Who is responsible for protocol
recommendation	ΣC	1..*	BackboneElement	Vaccine administration recommendations Constraints: imr-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
vaccineCode	Σ	0..*	CodeableConcept	Immunization Recommendation Vaccine Code Binding: CH VACD Swiss Vaccination Plan Immunizations (extensible)
targetDisease	SΣ	1..1	CodeableConcept	Disease to be immunized against Binding: CH VACD Target disease and illnesses undergone for immunization (extensible)
contraindicatedVaccineCode	Σ	0..*	CodeableConcept	Vaccine which is contraindicated to fulfill the recommendation Binding: VaccineAdministeredValueSet (example): The type of vaccine administered.
forecastStatus	?!Σ	1..1	CodeableConcept	Vaccine recommendation status Binding: CH VACD Swiss Recommendation Forecast Status (preferred): The reason the forecast is done.
forecastReason	SΣ	1..*	CodeableConcept	Vaccine administration status reason Binding: CH VACD Recommendation Categories for Immunizations (extensible)
dateCriterion	S	1..*	BackboneElement	Dates governing proposed 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
code		1..1	CodeableConcept	Type of date Binding: ImmunizationRecommendationDateCriterionCodes (example): Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.).
value		1..1	dateTime	Recommended date
description		0..1	string	Protocol details
series		0..1	string	Name of vaccination series
doseNumber[x]	Σ	0..1		Recommended dose number within series
doseNumberPositiveInt			positiveInt
doseNumberString			string
seriesDoses[x]		0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
supportingImmunization		0..*	Reference(CH Core Immunization | ImmunizationEvaluation)	Past immunizations supporting recommendation
supportingPatientInformation		0..*	Reference(Resource)	Patient observations supporting recommendation
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	CH VACD Swiss Vaccination Plan Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	CH VACD Target disease and illnesses undergone for immunization	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode	Base	example	Vaccine Administered Value Set	📍4.0.1	FHIR Std.
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	CH VACD Swiss Recommendation Forecast Status	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.forecastReason	Base	extensible	CH VACD Recommendation Categories for Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.dateCriterion.​code	Base	example	Immunization Recommendation Date Criterion Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ImmunizationRecommendation	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	ImmunizationRecommendation	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	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ImmunizationRecommendation	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()
imr-1	error	ImmunizationRecommendation.recommendation	One of vaccineCode or targetDisease SHALL be present	vaccineCode.exists() or targetDisease.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	CHCoreImmunizationRecommendation	CH VACD Immunization Recommendation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..1	Resource	ImmunizationRecommendation inline resource
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
patient	Σ	1..1	Reference(CH Core Patient)	Patient
date	Σ	1..1	dateTime	Date recommendation(s) created
recommendation	ΣC	1..*	BackboneElement	Vaccine administration recommendations Constraints: imr-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
vaccineCode	Σ	0..*	CodeableConcept	Immunization Recommendation Vaccine Code Binding: CH VACD Swiss Vaccination Plan Immunizations (extensible)
targetDisease	SΣ	1..1	CodeableConcept	Disease to be immunized against Binding: CH VACD Target disease and illnesses undergone for immunization (extensible)
forecastStatus	?!Σ	1..1	CodeableConcept	Vaccine recommendation status Binding: CH VACD Swiss Recommendation Forecast Status (preferred): The reason the forecast is done.
forecastReason	SΣ	1..*	CodeableConcept	Vaccine administration status reason Binding: CH VACD Recommendation Categories for Immunizations (extensible)
dateCriterion	S	1..*	BackboneElement	Dates governing proposed immunization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Type of date Binding: ImmunizationRecommendationDateCriterionCodes (example): Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.).
value		1..1	dateTime	Recommended date
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	CH VACD Swiss Vaccination Plan Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	CH VACD Target disease and illnesses undergone for immunization	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	CH VACD Swiss Recommendation Forecast Status	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.forecastReason	Base	extensible	CH VACD Recommendation Categories for Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.dateCriterion.​code	Base	example	Immunization Recommendation Date Criterion Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ImmunizationRecommendation	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	ImmunizationRecommendation	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	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ImmunizationRecommendation	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()
imr-1	error	ImmunizationRecommendation.recommendation	One of vaccineCode or targetDisease SHALL be present	vaccineCode.exists() or targetDisease.exists()

Differential View

This structure is derived from CHCoreImmunizationRecommendation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	CHCoreImmunizationRecommendation	CH VACD Immunization Recommendation
contained		0..1	Resource	ImmunizationRecommendation inline resource
recommendation
vaccineCode		0..*	CodeableConcept	Immunization Recommendation Vaccine Code Binding: CH VACD Swiss Vaccination Plan Immunizations (extensible)
targetDisease	S	1..1	CodeableConcept	Disease to be immunized against Binding: CH VACD Target disease and illnesses undergone for immunization (extensible)
forecastReason	S	1..*	CodeableConcept	Vaccine administration status reason Binding: CH VACD Recommendation Categories for Immunizations (extensible)
dateCriterion	S	1..*	BackboneElement	Dates governing proposed immunization
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	CH VACD Swiss Vaccination Plan Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	CH VACD Target disease and illnesses undergone for immunization	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.forecastReason	Base	extensible	CH VACD Recommendation Categories for Immunizations	📦3.3.0-ci-build	CH Term v3.3

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	CHCoreImmunizationRecommendation	CH VACD Immunization Recommendation
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..1	Resource	ImmunizationRecommendation inline resource
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier
patient	Σ	1..1	Reference(CH Core Patient)	Patient
date	Σ	1..1	dateTime	Date recommendation(s) created
authority		0..1	Reference(CH Core Organization)	Who is responsible for protocol
recommendation	ΣC	1..*	BackboneElement	Vaccine administration recommendations Constraints: imr-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
vaccineCode	Σ	0..*	CodeableConcept	Immunization Recommendation Vaccine Code Binding: CH VACD Swiss Vaccination Plan Immunizations (extensible)
targetDisease	SΣ	1..1	CodeableConcept	Disease to be immunized against Binding: CH VACD Target disease and illnesses undergone for immunization (extensible)
contraindicatedVaccineCode	Σ	0..*	CodeableConcept	Vaccine which is contraindicated to fulfill the recommendation Binding: VaccineAdministeredValueSet (example): The type of vaccine administered.
forecastStatus	?!Σ	1..1	CodeableConcept	Vaccine recommendation status Binding: CH VACD Swiss Recommendation Forecast Status (preferred): The reason the forecast is done.
forecastReason	SΣ	1..*	CodeableConcept	Vaccine administration status reason Binding: CH VACD Recommendation Categories for Immunizations (extensible)
dateCriterion	S	1..*	BackboneElement	Dates governing proposed 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
code		1..1	CodeableConcept	Type of date Binding: ImmunizationRecommendationDateCriterionCodes (example): Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.).
value		1..1	dateTime	Recommended date
description		0..1	string	Protocol details
series		0..1	string	Name of vaccination series
doseNumber[x]	Σ	0..1		Recommended dose number within series
doseNumberPositiveInt			positiveInt
doseNumberString			string
seriesDoses[x]		0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
supportingImmunization		0..*	Reference(CH Core Immunization | ImmunizationEvaluation)	Past immunizations supporting recommendation
supportingPatientInformation		0..*	Reference(Resource)	Patient observations supporting recommendation
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	CH VACD Swiss Vaccination Plan Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	CH VACD Target disease and illnesses undergone for immunization	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode	Base	example	Vaccine Administered Value Set	📍4.0.1	FHIR Std.
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	CH VACD Swiss Recommendation Forecast Status	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.forecastReason	Base	extensible	CH VACD Recommendation Categories for Immunizations	📦3.3.0-ci-build	CH Term v3.3
ImmunizationRecommendation.​recommendation.dateCriterion.​code	Base	example	Immunization Recommendation Date Criterion Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ImmunizationRecommendation	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	ImmunizationRecommendation	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	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ImmunizationRecommendation	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()
imr-1	error	ImmunizationRecommendation.recommendation	One of vaccineCode or targetDisease SHALL be present	vaccineCode.exists() or targetDisease.exists()

This structure is derived from CHCoreImmunizationRecommendation

Summary

Mandatory: 3 elements
Must-Support: 3 elements