Zambia Immunizations FHIR Implementation Guide, published by Jembi Health Systems. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/jembi/Zambia-Immunizations/ and changes regularly. See the Directory of published versions

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Resource Profile: Allergy Intolerance - Vaccination Allergic Reaction

Used to capture the patient's allergic reaction after previous vaccine dose.

Usage:

• Use this Resource Profile: Bundle - COVAX
• Examples for this Resource Profile: AllergyIntolerance/VaccinationAllergicReactionExample

Formal Views of Profile Content

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

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

This structure is derived from AllergyIntolerance

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance			AllergyIntolerance
type		1..1	CodeableConcept	allergy | intolerance - Underlying mechanism (if known) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/allergy-intolerance-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: allergy
category		1..1	code	food | medication | environment | biologic Required Pattern: medication
code		1..1	CodeableConcept	Code that identifies the allergy or intolerance Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 31044-1
patient		1..1	Reference(Patient - COVAX Immunization Patient)	Who the allergy or intolerance is for
encounter		1..1	Reference(Encounter - Target Facility Encounter (COVAX))	Encounter when the allergy or intolerance was asserted
Slices for onset[x]		1..1	dateTime	When allergy or intolerance was identified Slice: Unordered, Open by type:$this
onset[x]:onsetDateTime		1..1	dateTime	When allergy or intolerance was identified
recordedDate	S	0..1	dateTime	Date allergy or intolerance was first recorded
reaction		1..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
substance		1..1	CodeableConcept	Specific substance or pharmaceutical product considered to be responsible for event Binding: Vaccine Codes (extensible)
manifestation		1..*	CodeableReference(Observation - Immunization Allergy)	Clinical symptoms/signs associated with the Event
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
AllergyIntolerance.reaction.substance	extensible	VSVaccines http://moh.gov.zm/fhir/immunizations/ValueSet/vs-vaccines from this IG

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance		0..*	AllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!Σ	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!Σ	0..1	CodeableConcept	unconfirmed | presumed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatus (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
type	Σ	1..1	CodeableConcept	allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (preferred): Identification of the underlying physiological mechanism for a Reaction Risk. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/allergy-intolerance-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: allergy
category	Σ	1..1	code	food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances. Required Pattern: medication
code	Σ	1..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceProductAndConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 31044-1
patient	Σ	1..1	Reference(Patient - COVAX Immunization Patient)	Who the allergy or intolerance is for
encounter		1..1	Reference(Encounter - Target Facility Encounter (COVAX))	Encounter when the allergy or intolerance was asserted
Slices for onset[x]		1..1	dateTime	When allergy or intolerance was identified Slice: Unordered, Closed by type:$this
onset[x]:onsetDateTime		1..1	dateTime	When allergy or intolerance was identified
recordedDate	S	0..1	dateTime	Date allergy or intolerance was first recorded
reaction		1..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
substance		1..1	CodeableConcept	Specific substance or pharmaceutical product considered to be responsible for event Binding: Vaccine Codes (extensible)
manifestation		1..*	CodeableReference(Observation - Immunization Allergy)	Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
AllergyIntolerance.clinicalStatus	required	AllergyIntoleranceClinicalStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|5.0.0 from the FHIR Standard
AllergyIntolerance.verificationStatus	required	AllergyIntoleranceVerificationStatus http://hl7.org/fhir/ValueSet/allergyintolerance-verification|5.0.0 from the FHIR Standard
AllergyIntolerance.type	preferred	Pattern: allergy http://hl7.org/fhir/ValueSet/allergy-intolerance-type from the FHIR Standard
AllergyIntolerance.category	required	Pattern: medication http://hl7.org/fhir/ValueSet/allergy-intolerance-category|5.0.0 from the FHIR Standard
AllergyIntolerance.code	example	Pattern: LOINC Code 31044-1 http://hl7.org/fhir/ValueSet/allergyintolerance-code from the FHIR Standard
AllergyIntolerance.reaction.substance	extensible	VSVaccines http://moh.gov.zm/fhir/immunizations/ValueSet/vs-vaccines from this IG
AllergyIntolerance.reaction.manifestation	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	AllergyIntolerance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	AllergyIntolerance	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	AllergyIntolerance	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	AllergyIntolerance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	AllergyIntolerance	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()

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance		0..*	AllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
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: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter Set
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External ids for this item
clinicalStatus	?!Σ	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!Σ	0..1	CodeableConcept	unconfirmed | presumed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatus (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
type	Σ	1..1	CodeableConcept	allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (preferred): Identification of the underlying physiological mechanism for a Reaction Risk. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/allergy-intolerance-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: allergy
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category	Σ	1..1	code	food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances. Required Pattern: medication
criticality	Σ	0..1	code	low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code	Σ	1..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceProductAndConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 31044-1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(Patient - COVAX Immunization Patient)	Who the allergy or intolerance is for
encounter		1..1	Reference(Encounter - Target Facility Encounter (COVAX))	Encounter when the allergy or intolerance was asserted
Slices for onset[x]		1..1	dateTime	When allergy or intolerance was identified Slice: Unordered, Closed by type:$this
onset[x]:onsetDateTime		1..1	dateTime	When allergy or intolerance was identified
recordedDate	S	0..1	dateTime	Date allergy or intolerance was first recorded
participant	Σ	0..*	BackboneElement	Who or what participated in the activities related to the allergy or intolerance and how they were involved
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	Type of involvement Binding: ParticipationRoleType (extensible)
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device | Organization | CareTeam)	Who or what participated in the activities related to the allergy or intolerance
lastOccurrence		0..1	dateTime	Date(/time) of last known occurrence of a reaction
note		0..*	Annotation	Additional text not captured in other fields
reaction		1..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
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
substance		1..1	CodeableConcept	Specific substance or pharmaceutical product considered to be responsible for event Binding: Vaccine Codes (extensible)
manifestation		1..*	CodeableReference(Observation - Immunization Allergy)	Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
description		0..1	string	Description of the event as a whole
onset		0..1	dateTime	Date(/time) when manifestations showed
severity		0..1	code	mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
exposureRoute		0..1	CodeableConcept	How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of exposure to a substance.
note		0..*	Annotation	Text about event not captured in other fields
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
AllergyIntolerance.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
AllergyIntolerance.clinicalStatus	required	AllergyIntoleranceClinicalStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|5.0.0 from the FHIR Standard
AllergyIntolerance.verificationStatus	required	AllergyIntoleranceVerificationStatus http://hl7.org/fhir/ValueSet/allergyintolerance-verification|5.0.0 from the FHIR Standard
AllergyIntolerance.type	preferred	Pattern: allergy http://hl7.org/fhir/ValueSet/allergy-intolerance-type from the FHIR Standard
AllergyIntolerance.category	required	Pattern: medication http://hl7.org/fhir/ValueSet/allergy-intolerance-category|5.0.0 from the FHIR Standard
AllergyIntolerance.criticality	required	AllergyIntoleranceCriticality http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|5.0.0 from the FHIR Standard
AllergyIntolerance.code	example	Pattern: LOINC Code 31044-1 http://hl7.org/fhir/ValueSet/allergyintolerance-code from the FHIR Standard
AllergyIntolerance.participant.function	extensible	ParticipationRoleType http://hl7.org/fhir/ValueSet/participation-role-type from the FHIR Standard
AllergyIntolerance.reaction.substance	extensible	VSVaccines http://moh.gov.zm/fhir/immunizations/ValueSet/vs-vaccines from this IG
AllergyIntolerance.reaction.manifestation	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
AllergyIntolerance.reaction.severity	required	AllergyIntoleranceSeverity http://hl7.org/fhir/ValueSet/reaction-event-severity|5.0.0 from the FHIR Standard
AllergyIntolerance.reaction.exposureRoute	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	AllergyIntolerance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	AllergyIntolerance	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	AllergyIntolerance	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	AllergyIntolerance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	AllergyIntolerance	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 AllergyIntolerance

Summary

Mandatory: 8 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

• Patient - COVAX Immunization Patient (http://moh.gov.zm/fhir/immunizations/StructureDefinition/covax-immunization-patient)
• Encounter - Target Facility Encounter (COVAX) (http://moh.gov.zm/fhir/immunizations/StructureDefinition/covax-target-facility-encounter)
• Observation - Immunization Allergy (http://moh.gov.zm/fhir/immunizations/StructureDefinition/immunization-allergy)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of AllergyIntolerance.onset[x]

Differential View

This structure is derived from AllergyIntolerance

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance			AllergyIntolerance
type		1..1	CodeableConcept	allergy | intolerance - Underlying mechanism (if known) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/allergy-intolerance-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: allergy
category		1..1	code	food | medication | environment | biologic Required Pattern: medication
code		1..1	CodeableConcept	Code that identifies the allergy or intolerance Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 31044-1
patient		1..1	Reference(Patient - COVAX Immunization Patient)	Who the allergy or intolerance is for
encounter		1..1	Reference(Encounter - Target Facility Encounter (COVAX))	Encounter when the allergy or intolerance was asserted
Slices for onset[x]		1..1	dateTime	When allergy or intolerance was identified Slice: Unordered, Open by type:$this
onset[x]:onsetDateTime		1..1	dateTime	When allergy or intolerance was identified
recordedDate	S	0..1	dateTime	Date allergy or intolerance was first recorded
reaction		1..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
substance		1..1	CodeableConcept	Specific substance or pharmaceutical product considered to be responsible for event Binding: Vaccine Codes (extensible)
manifestation		1..*	CodeableReference(Observation - Immunization Allergy)	Clinical symptoms/signs associated with the Event
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
AllergyIntolerance.reaction.substance	extensible	VSVaccines http://moh.gov.zm/fhir/immunizations/ValueSet/vs-vaccines from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance		0..*	AllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!Σ	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!Σ	0..1	CodeableConcept	unconfirmed | presumed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatus (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
type	Σ	1..1	CodeableConcept	allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (preferred): Identification of the underlying physiological mechanism for a Reaction Risk. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/allergy-intolerance-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: allergy
category	Σ	1..1	code	food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances. Required Pattern: medication
code	Σ	1..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceProductAndConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 31044-1
patient	Σ	1..1	Reference(Patient - COVAX Immunization Patient)	Who the allergy or intolerance is for
encounter		1..1	Reference(Encounter - Target Facility Encounter (COVAX))	Encounter when the allergy or intolerance was asserted
Slices for onset[x]		1..1	dateTime	When allergy or intolerance was identified Slice: Unordered, Closed by type:$this
onset[x]:onsetDateTime		1..1	dateTime	When allergy or intolerance was identified
recordedDate	S	0..1	dateTime	Date allergy or intolerance was first recorded
reaction		1..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
substance		1..1	CodeableConcept	Specific substance or pharmaceutical product considered to be responsible for event Binding: Vaccine Codes (extensible)
manifestation		1..*	CodeableReference(Observation - Immunization Allergy)	Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
AllergyIntolerance.clinicalStatus	required	AllergyIntoleranceClinicalStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|5.0.0 from the FHIR Standard
AllergyIntolerance.verificationStatus	required	AllergyIntoleranceVerificationStatus http://hl7.org/fhir/ValueSet/allergyintolerance-verification|5.0.0 from the FHIR Standard
AllergyIntolerance.type	preferred	Pattern: allergy http://hl7.org/fhir/ValueSet/allergy-intolerance-type from the FHIR Standard
AllergyIntolerance.category	required	Pattern: medication http://hl7.org/fhir/ValueSet/allergy-intolerance-category|5.0.0 from the FHIR Standard
AllergyIntolerance.code	example	Pattern: LOINC Code 31044-1 http://hl7.org/fhir/ValueSet/allergyintolerance-code from the FHIR Standard
AllergyIntolerance.reaction.substance	extensible	VSVaccines http://moh.gov.zm/fhir/immunizations/ValueSet/vs-vaccines from this IG
AllergyIntolerance.reaction.manifestation	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	AllergyIntolerance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	AllergyIntolerance	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	AllergyIntolerance	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	AllergyIntolerance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	AllergyIntolerance	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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance		0..*	AllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
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: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter Set
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External ids for this item
clinicalStatus	?!Σ	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!Σ	0..1	CodeableConcept	unconfirmed | presumed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatus (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
type	Σ	1..1	CodeableConcept	allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (preferred): Identification of the underlying physiological mechanism for a Reaction Risk. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/allergy-intolerance-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: allergy
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category	Σ	1..1	code	food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances. Required Pattern: medication
criticality	Σ	0..1	code	low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code	Σ	1..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceProductAndConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 31044-1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(Patient - COVAX Immunization Patient)	Who the allergy or intolerance is for
encounter		1..1	Reference(Encounter - Target Facility Encounter (COVAX))	Encounter when the allergy or intolerance was asserted
Slices for onset[x]		1..1	dateTime	When allergy or intolerance was identified Slice: Unordered, Closed by type:$this
onset[x]:onsetDateTime		1..1	dateTime	When allergy or intolerance was identified
recordedDate	S	0..1	dateTime	Date allergy or intolerance was first recorded
participant	Σ	0..*	BackboneElement	Who or what participated in the activities related to the allergy or intolerance and how they were involved
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	Type of involvement Binding: ParticipationRoleType (extensible)
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device | Organization | CareTeam)	Who or what participated in the activities related to the allergy or intolerance
lastOccurrence		0..1	dateTime	Date(/time) of last known occurrence of a reaction
note		0..*	Annotation	Additional text not captured in other fields
reaction		1..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
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
substance		1..1	CodeableConcept	Specific substance or pharmaceutical product considered to be responsible for event Binding: Vaccine Codes (extensible)
manifestation		1..*	CodeableReference(Observation - Immunization Allergy)	Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
description		0..1	string	Description of the event as a whole
onset		0..1	dateTime	Date(/time) when manifestations showed
severity		0..1	code	mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
exposureRoute		0..1	CodeableConcept	How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of exposure to a substance.
note		0..*	Annotation	Text about event not captured in other fields
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
AllergyIntolerance.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
AllergyIntolerance.clinicalStatus	required	AllergyIntoleranceClinicalStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|5.0.0 from the FHIR Standard
AllergyIntolerance.verificationStatus	required	AllergyIntoleranceVerificationStatus http://hl7.org/fhir/ValueSet/allergyintolerance-verification|5.0.0 from the FHIR Standard
AllergyIntolerance.type	preferred	Pattern: allergy http://hl7.org/fhir/ValueSet/allergy-intolerance-type from the FHIR Standard
AllergyIntolerance.category	required	Pattern: medication http://hl7.org/fhir/ValueSet/allergy-intolerance-category|5.0.0 from the FHIR Standard
AllergyIntolerance.criticality	required	AllergyIntoleranceCriticality http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|5.0.0 from the FHIR Standard
AllergyIntolerance.code	example	Pattern: LOINC Code 31044-1 http://hl7.org/fhir/ValueSet/allergyintolerance-code from the FHIR Standard
AllergyIntolerance.participant.function	extensible	ParticipationRoleType http://hl7.org/fhir/ValueSet/participation-role-type from the FHIR Standard
AllergyIntolerance.reaction.substance	extensible	VSVaccines http://moh.gov.zm/fhir/immunizations/ValueSet/vs-vaccines from this IG
AllergyIntolerance.reaction.manifestation	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
AllergyIntolerance.reaction.severity	required	AllergyIntoleranceSeverity http://hl7.org/fhir/ValueSet/reaction-event-severity|5.0.0 from the FHIR Standard
AllergyIntolerance.reaction.exposureRoute	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	AllergyIntolerance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	AllergyIntolerance	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	AllergyIntolerance	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	AllergyIntolerance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	AllergyIntolerance	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 AllergyIntolerance

Summary

Mandatory: 8 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

• Patient - COVAX Immunization Patient (http://moh.gov.zm/fhir/immunizations/StructureDefinition/covax-immunization-patient)
• Encounter - Target Facility Encounter (COVAX) (http://moh.gov.zm/fhir/immunizations/StructureDefinition/covax-target-facility-encounter)
• Observation - Immunization Allergy (http://moh.gov.zm/fhir/immunizations/StructureDefinition/immunization-allergy)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of AllergyIntolerance.onset[x]

Other representations of profile: CSV, Excel, Schematron