PH eReferral Implementation Guide
0.1.0 - ci-build Philippines flag

PH eReferral Implementation Guide, published by SILab CoP IG Accelerator (eReferral). 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/jldalisay95/ph-ereferral-jld/ and changes regularly. See the Directory of published versions

Resource Profile: ERefImmunization - Detailed Descriptions

Draft as of 2026-04-29

Definitions for the ereferral-immunization resource profile

Guidance on how to interpret the contents of this table can be foundhere

0. Immunization
Definition

Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.

ShortImmunization event information
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Immunization.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Immunization.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Immunization.status
Definition

Indicates the current status of the immunization event.

Shortcompleted | entered-in-error | not-done
Comments

Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from ImmunizationStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/immunization-status|4.0.1)

A set of codes indicating the current status of an Immunization.

Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Immunization.statusReason
Definition

Indicates the reason the immunization event was not performed.

ShortReason not done
Comments

This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.

Control0..1
BindingFor example codes, see ImmunizationStatusReasonCodeshttp://hl7.org/fhir/ValueSet/immunization-status-reason|4.0.1
(example to http://hl7.org/fhir/ValueSet/immunization-status-reason|4.0.1)

The reason why a vaccine was not administered.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Obligations
    ObligationsActorSource
    SHALL:handlePH Core Serverfrom PH Core Immunization
    SHALL:handlePH Core Consumerfrom PH Core Immunization
    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. Immunization.statusReason.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control0..*
    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Obligations
      ObligationsActorSource
      SHALL:handlePH Core Serverfrom PH Core Immunization
      SHALL:handlePH Core Consumerfrom PH Core Immunization
      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Immunization.statusReason.text
      Definition

      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      ShortPlain text representation of the concept
      Comments

      Very often the text is the same as a displayName of one of the codings.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Obligations
        ObligationsActorSource
        SHALL:handlePH Core Serverfrom PH Core Immunization
        SHALL:handlePH Core Consumerfrom PH Core Immunization
        MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
        Summarytrue
        Requirements

        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. Immunization.vaccineCode
        Definition

        Vaccine that was administered or was to be administered. Supports CVX, ICD-11, or locally defined Philippine vaccine codes.


        Vaccine that was administered or was to be administered.

        ShortVaccine product administered
        Control1..1
        BindingFor example codes, see VaccineAdministeredValueSethttp://hl7.org/fhir/ValueSet/vaccine-code|4.0.1
        (example to http://hl7.org/fhir/ValueSet/vaccine-code|4.0.1)

        The code for vaccine product administered.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Obligations
          ObligationsActorSource
          SHALL:handlePH Core Serverfrom PH Core Immunization
          SHALL:handlePH Core Consumerfrom PH Core Immunization
          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. Immunization.vaccineCode.coding
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control0..*
          TypeCoding
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActorSource
            SHALL:handlePH Core Serverfrom PH Core Immunization
            SHALL:handlePH Core Consumerfrom PH Core Immunization
            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            18. Immunization.vaccineCode.text
            Definition

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            ShortPlain text representation of the concept
            Comments

            Very often the text is the same as a displayName of one of the codings.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Obligations
              ObligationsActorSource
              SHALL:handlePH Core Serverfrom PH Core Immunization
              SHALL:handlePH Core Consumerfrom PH Core Immunization
              MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
              Summarytrue
              Requirements

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. Immunization.patient
              Definition

              The patient who either received or did not receive the immunization.

              ShortPatient who was immunizedWho was immunized
              Control1..1
              TypeReference(ERefPatient, Patient)
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. Immunization.occurrence[x]
              Definition

              Date vaccine administered or was to be administered.

              ShortVaccine administration date
              Comments

              When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

              Control1..1
              TypeChoice of: dateTime, string
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. Immunization.reportOrigin
              Definition

              The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

              ShortIndicates the source of a secondarily reported record
              Comments

              Should not be populated if primarySource = True, not required even if primarySource = False.

              Control0..1
              BindingFor example codes, see ImmunizationOriginCodeshttp://hl7.org/fhir/ValueSet/immunization-origin|4.0.1
              (example to http://hl7.org/fhir/ValueSet/immunization-origin|4.0.1)

              The source of the data for a record which is not from a primary source.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Obligations
                ObligationsActorSource
                SHALL:handlePH Core Serverfrom PH Core Immunization
                SHALL:handlePH Core Consumerfrom PH Core Immunization
                MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                26. Immunization.reportOrigin.coding
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Control0..*
                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Obligations
                  ObligationsActorSource
                  SHALL:handlePH Core Serverfrom PH Core Immunization
                  SHALL:handlePH Core Consumerfrom PH Core Immunization
                  MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  28. Immunization.reportOrigin.text
                  Definition

                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                  ShortPlain text representation of the concept
                  Comments

                  Very often the text is the same as a displayName of one of the codings.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Obligations
                    ObligationsActorSource
                    SHALL:handlePH Core Serverfrom PH Core Immunization
                    SHALL:handlePH Core Consumerfrom PH Core Immunization
                    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                    Summarytrue
                    Requirements

                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    30. Immunization.site
                    Definition

                    Body site where vaccine was administered.

                    ShortBody site vaccine was administered
                    Control0..1
                    BindingFor example codes, see CodesForImmunizationSiteOfAdministrationhttp://hl7.org/fhir/ValueSet/immunization-site|4.0.1
                    (example to http://hl7.org/fhir/ValueSet/immunization-site|4.0.1)

                    The site at which the vaccine was administered.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Obligations
                      ObligationsActorSource
                      SHALL:handlePH Core Serverfrom PH Core Immunization
                      SHALL:handlePH Core Consumerfrom PH Core Immunization
                      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      32. Immunization.site.coding
                      Definition

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      Comments

                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                      Control0..*
                      TypeCoding
                      Is Modifierfalse
                      Must Supporttrue
                      Obligations
                        ObligationsActorSource
                        SHALL:handlePH Core Serverfrom PH Core Immunization
                        SHALL:handlePH Core Consumerfrom PH Core Immunization
                        MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                        Summarytrue
                        Requirements

                        Allows for alternative encodings within a code system, and translations to other code systems.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        34. Immunization.site.text
                        Definition

                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                        ShortPlain text representation of the concept
                        Comments

                        Very often the text is the same as a displayName of one of the codings.

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Obligations
                          ObligationsActorSource
                          SHALL:handlePH Core Serverfrom PH Core Immunization
                          SHALL:handlePH Core Consumerfrom PH Core Immunization
                          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                          Summarytrue
                          Requirements

                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          36. Immunization.route
                          Definition

                          The path by which the vaccine product is taken into the body.

                          ShortHow vaccine entered body
                          Control0..1
                          BindingFor example codes, see ImmunizationRouteCodeshttp://hl7.org/fhir/ValueSet/immunization-route|4.0.1
                          (example to http://hl7.org/fhir/ValueSet/immunization-route|4.0.1)

                          The route by which the vaccine was administered.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Obligations
                            ObligationsActorSource
                            SHALL:handlePH Core Serverfrom PH Core Immunization
                            SHALL:handlePH Core Consumerfrom PH Core Immunization
                            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            38. Immunization.route.coding
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode defined by a terminology system
                            Comments

                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                            Control0..*
                            TypeCoding
                            Is Modifierfalse
                            Must Supporttrue
                            Obligations
                              ObligationsActorSource
                              SHALL:handlePH Core Serverfrom PH Core Immunization
                              SHALL:handlePH Core Consumerfrom PH Core Immunization
                              MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                              Summarytrue
                              Requirements

                              Allows for alternative encodings within a code system, and translations to other code systems.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              40. Immunization.route.text
                              Definition

                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                              ShortPlain text representation of the concept
                              Comments

                              Very often the text is the same as a displayName of one of the codings.

                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Obligations
                                ObligationsActorSource
                                SHALL:handlePH Core Serverfrom PH Core Immunization
                                SHALL:handlePH Core Consumerfrom PH Core Immunization
                                MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                Summarytrue
                                Requirements

                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                42. Immunization.performer
                                Definition

                                Indicates who performed the immunization event.

                                ShortWho performed event
                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                44. Immunization.performer.modifierExtension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                Summarytrue
                                Requirements

                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                Alternate Namesextensions, user content, modifiers
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                46. Immunization.performer.function
                                Definition

                                Describes the type of performance (e.g. ordering provider, administering provider, etc.).

                                ShortWhat type of performance was done
                                Control0..1
                                BindingUnless not suitable, these codes SHALL be taken from ImmunizationFunctionCodeshttp://hl7.org/fhir/ValueSet/immunization-function|4.0.1
                                (extensible to http://hl7.org/fhir/ValueSet/immunization-function|4.0.1)

                                The role a practitioner or organization plays in the immunization event.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Obligations
                                  ObligationsActorSource
                                  SHALL:handlePH Core Serverfrom PH Core Immunization
                                  SHALL:handlePH Core Consumerfrom PH Core Immunization
                                  MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  48. Immunization.performer.function.coding
                                  Definition

                                  A reference to a code defined by a terminology system.

                                  ShortCode defined by a terminology system
                                  Comments

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                  Control0..*
                                  TypeCoding
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActorSource
                                    SHALL:handlePH Core Serverfrom PH Core Immunization
                                    SHALL:handlePH Core Consumerfrom PH Core Immunization
                                    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                    Summarytrue
                                    Requirements

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    50. Immunization.performer.function.text
                                    Definition

                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                    ShortPlain text representation of the concept
                                    Comments

                                    Very often the text is the same as a displayName of one of the codings.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActorSource
                                      SHALL:handlePH Core Serverfrom PH Core Immunization
                                      SHALL:handlePH Core Consumerfrom PH Core Immunization
                                      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                      Summarytrue
                                      Requirements

                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      52. Immunization.performer.actor
                                      Definition

                                      The practitioner or organization who performed the action.

                                      ShortIndividual or organization who was performing
                                      Comments

                                      When the individual practitioner who performed the action is known, it is best to send.

                                      Control1..1
                                      TypeReference(Practitioner, PractitionerRole, Organization)
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      54. Immunization.reasonCode
                                      Definition

                                      Reasons why the vaccine was administered.

                                      ShortWhy immunization occurred
                                      Control0..*
                                      BindingFor example codes, see ImmunizationReasonCodeshttp://hl7.org/fhir/ValueSet/immunization-reason|4.0.1
                                      (example to http://hl7.org/fhir/ValueSet/immunization-reason|4.0.1)

                                      The reason why a vaccine was administered.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActorSource
                                        SHALL:handlePH Core Serverfrom PH Core Immunization
                                        SHALL:handlePH Core Consumerfrom PH Core Immunization
                                        MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        56. Immunization.reasonCode.coding
                                        Definition

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                        Control0..*
                                        TypeCoding
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActorSource
                                          SHALL:handlePH Core Serverfrom PH Core Immunization
                                          SHALL:handlePH Core Consumerfrom PH Core Immunization
                                          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                          Summarytrue
                                          Requirements

                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          58. Immunization.reasonCode.text
                                          Definition

                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                          ShortPlain text representation of the concept
                                          Comments

                                          Very often the text is the same as a displayName of one of the codings.

                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActorSource
                                            SHALL:handlePH Core Serverfrom PH Core Immunization
                                            SHALL:handlePH Core Consumerfrom PH Core Immunization
                                            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                            Summarytrue
                                            Requirements

                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            60. Immunization.isSubpotent
                                            Definition

                                            Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

                                            ShortDose potency
                                            Comments

                                            Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

                                            Control0..1
                                            Typeboolean
                                            Is Modifiertrue because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Meaning if MissingBy default, a dose should be considered to be potent.
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            62. Immunization.subpotentReason
                                            Definition

                                            Reason why a dose is considered to be subpotent.

                                            ShortReason for being subpotent
                                            Control0..*
                                            BindingFor example codes, see ImmunizationSubpotentReasonhttp://hl7.org/fhir/ValueSet/immunization-subpotent-reason|4.0.1
                                            (example to http://hl7.org/fhir/ValueSet/immunization-subpotent-reason|4.0.1)

                                            The reason why a dose is considered to be subpotent.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActorSource
                                              SHALL:handlePH Core Serverfrom PH Core Immunization
                                              SHALL:handlePH Core Consumerfrom PH Core Immunization
                                              MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              64. Immunization.subpotentReason.coding
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                              Control0..*
                                              TypeCoding
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActorSource
                                                SHALL:handlePH Core Serverfrom PH Core Immunization
                                                SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                Summarytrue
                                                Requirements

                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                66. Immunization.subpotentReason.text
                                                Definition

                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                ShortPlain text representation of the concept
                                                Comments

                                                Very often the text is the same as a displayName of one of the codings.

                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActorSource
                                                  SHALL:handlePH Core Serverfrom PH Core Immunization
                                                  SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                  MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                  Summarytrue
                                                  Requirements

                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  68. Immunization.programEligibility
                                                  Definition

                                                  Indicates a patient's eligibility for a funding program.

                                                  ShortPatient eligibility for a vaccination program
                                                  Control0..*
                                                  BindingFor example codes, see ImmunizationProgramEligibilityhttp://hl7.org/fhir/ValueSet/immunization-program-eligibility|4.0.1
                                                  (example to http://hl7.org/fhir/ValueSet/immunization-program-eligibility|4.0.1)

                                                  The patient's eligibility for a vaccation program.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActorSource
                                                    SHALL:handlePH Core Serverfrom PH Core Immunization
                                                    SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    70. Immunization.programEligibility.coding
                                                    Definition

                                                    A reference to a code defined by a terminology system.

                                                    ShortCode defined by a terminology system
                                                    Comments

                                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                    Control0..*
                                                    TypeCoding
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Obligations
                                                      ObligationsActorSource
                                                      SHALL:handlePH Core Serverfrom PH Core Immunization
                                                      SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                      Summarytrue
                                                      Requirements

                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      72. Immunization.programEligibility.text
                                                      Definition

                                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                      ShortPlain text representation of the concept
                                                      Comments

                                                      Very often the text is the same as a displayName of one of the codings.

                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Obligations
                                                        ObligationsActorSource
                                                        SHALL:handlePH Core Serverfrom PH Core Immunization
                                                        SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                        MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                        Summarytrue
                                                        Requirements

                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        74. Immunization.fundingSource
                                                        Definition

                                                        Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).

                                                        ShortFunding source for the vaccine
                                                        Control0..1
                                                        BindingFor example codes, see ImmunizationFundingSourcehttp://hl7.org/fhir/ValueSet/immunization-funding-source|4.0.1
                                                        (example to http://hl7.org/fhir/ValueSet/immunization-funding-source|4.0.1)

                                                        The source of funding used to purchase the vaccine administered.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Obligations
                                                          ObligationsActorSource
                                                          SHALL:handlePH Core Serverfrom PH Core Immunization
                                                          SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          76. Immunization.fundingSource.coding
                                                          Definition

                                                          A reference to a code defined by a terminology system.

                                                          ShortCode defined by a terminology system
                                                          Comments

                                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                          Control0..*
                                                          TypeCoding
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Obligations
                                                            ObligationsActorSource
                                                            SHALL:handlePH Core Serverfrom PH Core Immunization
                                                            SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                            Summarytrue
                                                            Requirements

                                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            78. Immunization.fundingSource.text
                                                            Definition

                                                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                            ShortPlain text representation of the concept
                                                            Comments

                                                            Very often the text is the same as a displayName of one of the codings.

                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Obligations
                                                              ObligationsActorSource
                                                              SHALL:handlePH Core Serverfrom PH Core Immunization
                                                              SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                              MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                              Summarytrue
                                                              Requirements

                                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              80. Immunization.protocolApplied
                                                              Definition

                                                              The protocol (set of recommendations) being followed by the provider who administered the dose.

                                                              ShortProtocol followed by the provider
                                                              Control0..*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              82. Immunization.protocolApplied.modifierExtension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                              Summarytrue
                                                              Requirements

                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                              Alternate Namesextensions, user content, modifiers
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              84. Immunization.protocolApplied.targetDisease
                                                              Definition

                                                              The vaccine preventable disease the dose is being administered against.

                                                              ShortVaccine preventatable disease being targetted
                                                              Control0..*
                                                              BindingFor example codes, see ImmunizationTargetDiseaseCodeshttp://hl7.org/fhir/ValueSet/immunization-target-disease|4.0.1
                                                              (example to http://hl7.org/fhir/ValueSet/immunization-target-disease|4.0.1)

                                                              The vaccine preventable disease the dose is being administered for.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Obligations
                                                                ObligationsActorSource
                                                                SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                86. Immunization.protocolApplied.targetDisease.coding
                                                                Definition

                                                                A reference to a code defined by a terminology system.

                                                                ShortCode defined by a terminology system
                                                                Comments

                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                Control0..*
                                                                TypeCoding
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Obligations
                                                                  ObligationsActorSource
                                                                  SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                  SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                  MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                  Summarytrue
                                                                  Requirements

                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  88. Immunization.protocolApplied.targetDisease.text
                                                                  Definition

                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                  ShortPlain text representation of the concept
                                                                  Comments

                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supporttrue
                                                                  Obligations
                                                                    ObligationsActorSource
                                                                    SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                    SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                    Summarytrue
                                                                    Requirements

                                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    90. Immunization.protocolApplied.doseNumber[x]
                                                                    Definition

                                                                    Nominal position in a series.

                                                                    ShortDose number within series
                                                                    Comments

                                                                    The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).

                                                                    Control1..1
                                                                    TypeChoice of: positiveInt, string
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                                                                    Guidance on how to interpret the contents of this table can be foundhere

                                                                    0. Immunization
                                                                    2. Immunization.status
                                                                    Must Supporttrue
                                                                    4. Immunization.vaccineCode
                                                                    Definition

                                                                    Vaccine that was administered or was to be administered. Supports CVX, ICD-11, or locally defined Philippine vaccine codes.

                                                                    6. Immunization.patient
                                                                    ShortPatient who was immunized
                                                                    TypeReference(ERefPatient)
                                                                    Must Supporttrue
                                                                    8. Immunization.occurrence[x]
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Must Supporttrue

                                                                    Guidance on how to interpret the contents of this table can be foundhere

                                                                    0. Immunization
                                                                    Definition

                                                                    Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.

                                                                    ShortImmunization event information
                                                                    Control0..*
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                                    dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                                    dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                                    2. Immunization.id
                                                                    Definition

                                                                    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                                    ShortLogical id of this artifact
                                                                    Comments

                                                                    The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                                    Control0..1
                                                                    Typeid
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    4. Immunization.meta
                                                                    Definition

                                                                    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                                    ShortMetadata about the resource
                                                                    Control0..1
                                                                    TypeMeta
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    6. Immunization.implicitRules
                                                                    Definition

                                                                    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                                    ShortA set of rules under which this content was created
                                                                    Comments

                                                                    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                                    Control0..1
                                                                    Typeuri
                                                                    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    8. Immunization.language
                                                                    Definition

                                                                    The base language in which the resource is written.

                                                                    ShortLanguage of the resource content
                                                                    Comments

                                                                    Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                                                    Control0..1
                                                                    BindingThe codes SHOULD be taken from CommonLanguages
                                                                    (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                                                    A human language.

                                                                    Additional BindingsPurpose
                                                                    AllLanguagesMax Binding
                                                                    Typecode
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    10. Immunization.text
                                                                    Definition

                                                                    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                                    ShortText summary of the resource, for human interpretation
                                                                    Comments

                                                                    Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                                    Control0..1
                                                                    TypeNarrative
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesnarrative, html, xhtml, display
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    12. Immunization.contained
                                                                    Definition

                                                                    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                                                    ShortContained, inline Resources
                                                                    Comments

                                                                    This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                                    Control0..*
                                                                    TypeResource
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesinline resources, anonymous resources, contained resources
                                                                    14. Immunization.extension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    16. Immunization.modifierExtension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                    ShortExtensions that cannot be ignored
                                                                    Comments

                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    18. Immunization.identifier
                                                                    Definition

                                                                    A unique identifier assigned to this immunization record.

                                                                    ShortBusiness identifier
                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                    Control0..*
                                                                    TypeIdentifier
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    20. Immunization.status
                                                                    Definition

                                                                    Indicates the current status of the immunization event.

                                                                    Shortcompleted | entered-in-error | not-done
                                                                    Comments

                                                                    Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                                    Control1..1
                                                                    BindingThe codes SHALL be taken from ImmunizationStatusCodes
                                                                    (required to http://hl7.org/fhir/ValueSet/immunization-status|4.0.1)

                                                                    A set of codes indicating the current status of an Immunization.

                                                                    Typecode
                                                                    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    22. Immunization.statusReason
                                                                    Definition

                                                                    Indicates the reason the immunization event was not performed.

                                                                    ShortReason not done
                                                                    Comments

                                                                    This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.

                                                                    Control0..1
                                                                    BindingFor example codes, see ImmunizationStatusReasonCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/immunization-status-reason|4.0.1)

                                                                    The reason why a vaccine was not administered.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Obligations
                                                                      ObligationsActorSource
                                                                      SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                      SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      24. Immunization.statusReason.id
                                                                      Definition

                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Summaryfalse
                                                                      26. Immunization.statusReason.extension
                                                                      Definition

                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                      ShortAdditional content defined by implementations
                                                                      Comments

                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Alternate Namesextensions, user content
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      SlicingThis element introduces a set of slices on Immunization.statusReason.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 28. Immunization.statusReason.coding
                                                                        Definition

                                                                        A reference to a code defined by a terminology system.

                                                                        ShortCode defined by a terminology system
                                                                        Comments

                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                        Control0..*
                                                                        TypeCoding
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Obligations
                                                                          ObligationsActorSource
                                                                          SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                          SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                          Summarytrue
                                                                          Requirements

                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          30. Immunization.statusReason.text
                                                                          Definition

                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                          ShortPlain text representation of the concept
                                                                          Comments

                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Obligations
                                                                            ObligationsActorSource
                                                                            SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                            SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                            Summarytrue
                                                                            Requirements

                                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            32. Immunization.vaccineCode
                                                                            Definition

                                                                            Vaccine that was administered or was to be administered. Supports CVX, ICD-11, or locally defined Philippine vaccine codes.

                                                                            ShortVaccine product administered
                                                                            Control1..1
                                                                            BindingFor example codes, see VaccineAdministeredValueSet
                                                                            (example to http://hl7.org/fhir/ValueSet/vaccine-code|4.0.1)

                                                                            The code for vaccine product administered.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Obligations
                                                                              ObligationsActorSource
                                                                              SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                              SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                              MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              34. Immunization.vaccineCode.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              36. Immunization.vaccineCode.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                              ShortAdditional content defined by implementations
                                                                              Comments

                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on Immunization.vaccineCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 38. Immunization.vaccineCode.coding
                                                                                Definition

                                                                                A reference to a code defined by a terminology system.

                                                                                ShortCode defined by a terminology system
                                                                                Comments

                                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                Control0..*
                                                                                TypeCoding
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Obligations
                                                                                  ObligationsActorSource
                                                                                  SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                  SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                  MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  40. Immunization.vaccineCode.text
                                                                                  Definition

                                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                  ShortPlain text representation of the concept
                                                                                  Comments

                                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Obligations
                                                                                    ObligationsActorSource
                                                                                    SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                    SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    42. Immunization.patient
                                                                                    Definition

                                                                                    The patient who either received or did not receive the immunization.

                                                                                    ShortPatient who was immunized
                                                                                    Control1..1
                                                                                    TypeReference(ERefPatient)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    44. Immunization.encounter
                                                                                    Definition

                                                                                    The visit or admission or other contact between patient and health care provider the immunization was performed as part of.

                                                                                    ShortEncounter immunization was part of
                                                                                    Control0..1
                                                                                    TypeReference(PH Core Encounter)
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    46. Immunization.occurrence[x]
                                                                                    Definition

                                                                                    Date vaccine administered or was to be administered.

                                                                                    ShortVaccine administration date
                                                                                    Comments

                                                                                    When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

                                                                                    Control1..1
                                                                                    TypeChoice of: dateTime, string
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    48. Immunization.recorded
                                                                                    Definition

                                                                                    The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.

                                                                                    ShortWhen the immunization was first captured in the subject's record
                                                                                    Control0..1
                                                                                    TypedateTime
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    50. Immunization.primarySource
                                                                                    Definition

                                                                                    An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.

                                                                                    ShortIndicates context the data was recorded in
                                                                                    Comments

                                                                                    Reflects the “reliability” of the content.

                                                                                    Control0..1
                                                                                    Typeboolean
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    52. Immunization.reportOrigin
                                                                                    Definition

                                                                                    The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

                                                                                    ShortIndicates the source of a secondarily reported record
                                                                                    Comments

                                                                                    Should not be populated if primarySource = True, not required even if primarySource = False.

                                                                                    Control0..1
                                                                                    BindingFor example codes, see ImmunizationOriginCodes
                                                                                    (example to http://hl7.org/fhir/ValueSet/immunization-origin|4.0.1)

                                                                                    The source of the data for a record which is not from a primary source.

                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Obligations
                                                                                      ObligationsActorSource
                                                                                      SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                      SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      54. Immunization.reportOrigin.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      56. Immunization.reportOrigin.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      SlicingThis element introduces a set of slices on Immunization.reportOrigin.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 58. Immunization.reportOrigin.coding
                                                                                        Definition

                                                                                        A reference to a code defined by a terminology system.

                                                                                        ShortCode defined by a terminology system
                                                                                        Comments

                                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                        Control0..*
                                                                                        TypeCoding
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Obligations
                                                                                          ObligationsActorSource
                                                                                          SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                          SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          60. Immunization.reportOrigin.text
                                                                                          Definition

                                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                          ShortPlain text representation of the concept
                                                                                          Comments

                                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Must Supporttrue
                                                                                          Obligations
                                                                                            ObligationsActorSource
                                                                                            SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                            SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            62. Immunization.location
                                                                                            Definition

                                                                                            The service delivery location where the vaccine administration occurred.

                                                                                            ShortWhere immunization occurred
                                                                                            Control0..1
                                                                                            TypeReference(Location)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            64. Immunization.manufacturer
                                                                                            Definition

                                                                                            Name of vaccine manufacturer.

                                                                                            ShortVaccine manufacturer
                                                                                            Control0..1
                                                                                            TypeReference(Organization)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            66. Immunization.lotNumber
                                                                                            Definition

                                                                                            Lot number of the vaccine product.

                                                                                            ShortVaccine lot number
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            68. Immunization.expirationDate
                                                                                            Definition

                                                                                            Date vaccine batch expires.

                                                                                            ShortVaccine expiration date
                                                                                            Control0..1
                                                                                            Typedate
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            70. Immunization.site
                                                                                            Definition

                                                                                            Body site where vaccine was administered.

                                                                                            ShortBody site vaccine was administered
                                                                                            Control0..1
                                                                                            BindingFor example codes, see CodesForImmunizationSiteOfAdministration
                                                                                            (example to http://hl7.org/fhir/ValueSet/immunization-site|4.0.1)

                                                                                            The site at which the vaccine was administered.

                                                                                            TypeCodeableConcept
                                                                                            Is Modifierfalse
                                                                                            Must Supporttrue
                                                                                            Obligations
                                                                                              ObligationsActorSource
                                                                                              SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                              SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                              MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              72. Immunization.site.id
                                                                                              Definition

                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                              ShortUnique id for inter-element referencing
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Is Modifierfalse
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              Summaryfalse
                                                                                              74. Immunization.site.extension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                              ShortAdditional content defined by implementations
                                                                                              Comments

                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Alternate Namesextensions, user content
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              SlicingThis element introduces a set of slices on Immunization.site.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • value @ url
                                                                                              • 76. Immunization.site.coding
                                                                                                Definition

                                                                                                A reference to a code defined by a terminology system.

                                                                                                ShortCode defined by a terminology system
                                                                                                Comments

                                                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                Control0..*
                                                                                                TypeCoding
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Obligations
                                                                                                  ObligationsActorSource
                                                                                                  SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                  SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                  MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  78. Immunization.site.text
                                                                                                  Definition

                                                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                  ShortPlain text representation of the concept
                                                                                                  Comments

                                                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  Is Modifierfalse
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Must Supporttrue
                                                                                                  Obligations
                                                                                                    ObligationsActorSource
                                                                                                    SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                    SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    80. Immunization.route
                                                                                                    Definition

                                                                                                    The path by which the vaccine product is taken into the body.

                                                                                                    ShortHow vaccine entered body
                                                                                                    Control0..1
                                                                                                    BindingFor example codes, see ImmunizationRouteCodes
                                                                                                    (example to http://hl7.org/fhir/ValueSet/immunization-route|4.0.1)

                                                                                                    The route by which the vaccine was administered.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Must Supporttrue
                                                                                                    Obligations
                                                                                                      ObligationsActorSource
                                                                                                      SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                      SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      82. Immunization.route.id
                                                                                                      Definition

                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                      ShortUnique id for inter-element referencing
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Is Modifierfalse
                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                      Summaryfalse
                                                                                                      84. Immunization.route.extension
                                                                                                      Definition

                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                      ShortAdditional content defined by implementations
                                                                                                      Comments

                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                      Control0..*
                                                                                                      TypeExtension
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Alternate Namesextensions, user content
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      SlicingThis element introduces a set of slices on Immunization.route.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ url
                                                                                                      • 86. Immunization.route.coding
                                                                                                        Definition

                                                                                                        A reference to a code defined by a terminology system.

                                                                                                        ShortCode defined by a terminology system
                                                                                                        Comments

                                                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                        Control0..*
                                                                                                        TypeCoding
                                                                                                        Is Modifierfalse
                                                                                                        Must Supporttrue
                                                                                                        Obligations
                                                                                                          ObligationsActorSource
                                                                                                          SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                          SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          88. Immunization.route.text
                                                                                                          Definition

                                                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                          ShortPlain text representation of the concept
                                                                                                          Comments

                                                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Must Supporttrue
                                                                                                          Obligations
                                                                                                            ObligationsActorSource
                                                                                                            SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                            SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            90. Immunization.doseQuantity
                                                                                                            Definition

                                                                                                            The quantity of vaccine product that was administered.

                                                                                                            ShortAmount of vaccine administered
                                                                                                            Control0..1
                                                                                                            TypeQuantity(SimpleQuantity)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            92. Immunization.performer
                                                                                                            Definition

                                                                                                            Indicates who performed the immunization event.

                                                                                                            ShortWho performed event
                                                                                                            Control0..*
                                                                                                            TypeBackboneElement
                                                                                                            Is Modifierfalse
                                                                                                            Summarytrue
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            94. Immunization.performer.id
                                                                                                            Definition

                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                            ShortUnique id for inter-element referencing
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                            Summaryfalse
                                                                                                            96. Immunization.performer.extension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                            ShortAdditional content defined by implementations
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Alternate Namesextensions, user content
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            98. Immunization.performer.modifierExtension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            100. Immunization.performer.function
                                                                                                            Definition

                                                                                                            Describes the type of performance (e.g. ordering provider, administering provider, etc.).

                                                                                                            ShortWhat type of performance was done
                                                                                                            Control0..1
                                                                                                            BindingUnless not suitable, these codes SHALL be taken from ImmunizationFunctionCodes
                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/immunization-function|4.0.1)

                                                                                                            The role a practitioner or organization plays in the immunization event.

                                                                                                            TypeCodeableConcept
                                                                                                            Is Modifierfalse
                                                                                                            Must Supporttrue
                                                                                                            Obligations
                                                                                                              ObligationsActorSource
                                                                                                              SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                              SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                              MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                              Summarytrue
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              102. Immunization.performer.function.id
                                                                                                              Definition

                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                              ShortUnique id for inter-element referencing
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              Summaryfalse
                                                                                                              104. Immunization.performer.function.extension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                              ShortAdditional content defined by implementations
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Alternate Namesextensions, user content
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              SlicingThis element introduces a set of slices on Immunization.performer.function.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 106. Immunization.performer.function.coding
                                                                                                                Definition

                                                                                                                A reference to a code defined by a terminology system.

                                                                                                                ShortCode defined by a terminology system
                                                                                                                Comments

                                                                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                Control0..*
                                                                                                                TypeCoding
                                                                                                                Is Modifierfalse
                                                                                                                Must Supporttrue
                                                                                                                Obligations
                                                                                                                  ObligationsActorSource
                                                                                                                  SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                  SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                  MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                  Summarytrue
                                                                                                                  Requirements

                                                                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  108. Immunization.performer.function.text
                                                                                                                  Definition

                                                                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                  ShortPlain text representation of the concept
                                                                                                                  Comments

                                                                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                                                                  Control0..1
                                                                                                                  Typestring
                                                                                                                  Is Modifierfalse
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  Must Supporttrue
                                                                                                                  Obligations
                                                                                                                    ObligationsActorSource
                                                                                                                    SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                    SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    110. Immunization.performer.actor
                                                                                                                    Definition

                                                                                                                    The practitioner or organization who performed the action.

                                                                                                                    ShortIndividual or organization who was performing
                                                                                                                    Comments

                                                                                                                    When the individual practitioner who performed the action is known, it is best to send.

                                                                                                                    Control1..1
                                                                                                                    TypeReference(Practitioner, PractitionerRole, Organization)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summarytrue
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    112. Immunization.note
                                                                                                                    Definition

                                                                                                                    Extra information about the immunization that is not conveyed by the other attributes.

                                                                                                                    ShortAdditional immunization notes
                                                                                                                    Control0..*
                                                                                                                    TypeAnnotation
                                                                                                                    Is Modifierfalse
                                                                                                                    Summarytrue
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    114. Immunization.reasonCode
                                                                                                                    Definition

                                                                                                                    Reasons why the vaccine was administered.

                                                                                                                    ShortWhy immunization occurred
                                                                                                                    Control0..*
                                                                                                                    BindingFor example codes, see ImmunizationReasonCodes
                                                                                                                    (example to http://hl7.org/fhir/ValueSet/immunization-reason|4.0.1)

                                                                                                                    The reason why a vaccine was administered.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Is Modifierfalse
                                                                                                                    Must Supporttrue
                                                                                                                    Obligations
                                                                                                                      ObligationsActorSource
                                                                                                                      SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                      SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      116. Immunization.reasonCode.id
                                                                                                                      Definition

                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                      Control0..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                      Summaryfalse
                                                                                                                      118. Immunization.reasonCode.extension
                                                                                                                      Definition

                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                      Comments

                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                      Control0..*
                                                                                                                      TypeExtension
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Alternate Namesextensions, user content
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      SlicingThis element introduces a set of slices on Immunization.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                      • value @ url
                                                                                                                      • 120. Immunization.reasonCode.coding
                                                                                                                        Definition

                                                                                                                        A reference to a code defined by a terminology system.

                                                                                                                        ShortCode defined by a terminology system
                                                                                                                        Comments

                                                                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                        Control0..*
                                                                                                                        TypeCoding
                                                                                                                        Is Modifierfalse
                                                                                                                        Must Supporttrue
                                                                                                                        Obligations
                                                                                                                          ObligationsActorSource
                                                                                                                          SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                          SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          122. Immunization.reasonCode.text
                                                                                                                          Definition

                                                                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                          ShortPlain text representation of the concept
                                                                                                                          Comments

                                                                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                                                                          Control0..1
                                                                                                                          Typestring
                                                                                                                          Is Modifierfalse
                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                          Must Supporttrue
                                                                                                                          Obligations
                                                                                                                            ObligationsActorSource
                                                                                                                            SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                            SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                            Summarytrue
                                                                                                                            Requirements

                                                                                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            124. Immunization.reasonReference
                                                                                                                            Definition

                                                                                                                            Condition, Observation or DiagnosticReport that supports why the immunization was administered.

                                                                                                                            ShortWhy immunization occurred
                                                                                                                            Control0..*
                                                                                                                            TypeReference(Condition, Observation, DiagnosticReport)
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            126. Immunization.isSubpotent
                                                                                                                            Definition

                                                                                                                            Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

                                                                                                                            ShortDose potency
                                                                                                                            Comments

                                                                                                                            Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

                                                                                                                            Control0..1
                                                                                                                            Typeboolean
                                                                                                                            Is Modifiertrue because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                            Summarytrue
                                                                                                                            Meaning if MissingBy default, a dose should be considered to be potent.
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            128. Immunization.subpotentReason
                                                                                                                            Definition

                                                                                                                            Reason why a dose is considered to be subpotent.

                                                                                                                            ShortReason for being subpotent
                                                                                                                            Control0..*
                                                                                                                            BindingFor example codes, see ImmunizationSubpotentReason
                                                                                                                            (example to http://hl7.org/fhir/ValueSet/immunization-subpotent-reason|4.0.1)

                                                                                                                            The reason why a dose is considered to be subpotent.

                                                                                                                            TypeCodeableConcept
                                                                                                                            Is Modifierfalse
                                                                                                                            Must Supporttrue
                                                                                                                            Obligations
                                                                                                                              ObligationsActorSource
                                                                                                                              SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                              SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                              MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                              Summaryfalse
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              130. Immunization.subpotentReason.id
                                                                                                                              Definition

                                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                              ShortUnique id for inter-element referencing
                                                                                                                              Control0..1
                                                                                                                              Typestring
                                                                                                                              Is Modifierfalse
                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                              Summaryfalse
                                                                                                                              132. Immunization.subpotentReason.extension
                                                                                                                              Definition

                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                              ShortAdditional content defined by implementations
                                                                                                                              Comments

                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                              Control0..*
                                                                                                                              TypeExtension
                                                                                                                              Is Modifierfalse
                                                                                                                              Summaryfalse
                                                                                                                              Alternate Namesextensions, user content
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              SlicingThis element introduces a set of slices on Immunization.subpotentReason.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                              • value @ url
                                                                                                                              • 134. Immunization.subpotentReason.coding
                                                                                                                                Definition

                                                                                                                                A reference to a code defined by a terminology system.

                                                                                                                                ShortCode defined by a terminology system
                                                                                                                                Comments

                                                                                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                                Control0..*
                                                                                                                                TypeCoding
                                                                                                                                Is Modifierfalse
                                                                                                                                Must Supporttrue
                                                                                                                                Obligations
                                                                                                                                  ObligationsActorSource
                                                                                                                                  SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                  SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                  MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                  Summarytrue
                                                                                                                                  Requirements

                                                                                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  136. Immunization.subpotentReason.text
                                                                                                                                  Definition

                                                                                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                                  ShortPlain text representation of the concept
                                                                                                                                  Comments

                                                                                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                                                                                  Control0..1
                                                                                                                                  Typestring
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                  Must Supporttrue
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActorSource
                                                                                                                                    SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                    SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    138. Immunization.education
                                                                                                                                    Definition

                                                                                                                                    Educational material presented to the patient (or guardian) at the time of vaccine administration.

                                                                                                                                    ShortEducational material presented to patient
                                                                                                                                    Control0..*
                                                                                                                                    TypeBackboneElement
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Summaryfalse
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    imm-1: One of documentType or reference SHALL be present (documentType.exists() or reference.exists())
                                                                                                                                    140. Immunization.education.id
                                                                                                                                    Definition

                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                    Control0..1
                                                                                                                                    Typestring
                                                                                                                                    Is Modifierfalse
                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                    Summaryfalse
                                                                                                                                    142. Immunization.education.extension
                                                                                                                                    Definition

                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                    Comments

                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                    Control0..*
                                                                                                                                    TypeExtension
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Summaryfalse
                                                                                                                                    Alternate Namesextensions, user content
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                    144. Immunization.education.modifierExtension
                                                                                                                                    Definition

                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                    Comments

                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                    Control0..*
                                                                                                                                    TypeExtension
                                                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                    146. Immunization.education.documentType
                                                                                                                                    Definition

                                                                                                                                    Identifier of the material presented to the patient.

                                                                                                                                    ShortEducational material document identifier
                                                                                                                                    Control0..1
                                                                                                                                    Typestring
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                    Summaryfalse
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    148. Immunization.education.reference
                                                                                                                                    Definition

                                                                                                                                    Reference pointer to the educational material given to the patient if the information was on line.

                                                                                                                                    ShortEducational material reference pointer
                                                                                                                                    Control0..1
                                                                                                                                    Typeuri
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                    Summaryfalse
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    150. Immunization.education.publicationDate
                                                                                                                                    Definition

                                                                                                                                    Date the educational material was published.

                                                                                                                                    ShortEducational material publication date
                                                                                                                                    Control0..1
                                                                                                                                    TypedateTime
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                    Summaryfalse
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    152. Immunization.education.presentationDate
                                                                                                                                    Definition

                                                                                                                                    Date the educational material was given to the patient.

                                                                                                                                    ShortEducational material presentation date
                                                                                                                                    Control0..1
                                                                                                                                    TypedateTime
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                    Summaryfalse
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    154. Immunization.programEligibility
                                                                                                                                    Definition

                                                                                                                                    Indicates a patient's eligibility for a funding program.

                                                                                                                                    ShortPatient eligibility for a vaccination program
                                                                                                                                    Control0..*
                                                                                                                                    BindingFor example codes, see ImmunizationProgramEligibility
                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/immunization-program-eligibility|4.0.1)

                                                                                                                                    The patient's eligibility for a vaccation program.

                                                                                                                                    TypeCodeableConcept
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Must Supporttrue
                                                                                                                                    Obligations
                                                                                                                                      ObligationsActorSource
                                                                                                                                      SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                      SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                      Summaryfalse
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      156. Immunization.programEligibility.id
                                                                                                                                      Definition

                                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                                      Control0..1
                                                                                                                                      Typestring
                                                                                                                                      Is Modifierfalse
                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                      Summaryfalse
                                                                                                                                      158. Immunization.programEligibility.extension
                                                                                                                                      Definition

                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                      Comments

                                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                      Control0..*
                                                                                                                                      TypeExtension
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Summaryfalse
                                                                                                                                      Alternate Namesextensions, user content
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                      SlicingThis element introduces a set of slices on Immunization.programEligibility.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                      • value @ url
                                                                                                                                      • 160. Immunization.programEligibility.coding
                                                                                                                                        Definition

                                                                                                                                        A reference to a code defined by a terminology system.

                                                                                                                                        ShortCode defined by a terminology system
                                                                                                                                        Comments

                                                                                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                                        Control0..*
                                                                                                                                        TypeCoding
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Must Supporttrue
                                                                                                                                        Obligations
                                                                                                                                          ObligationsActorSource
                                                                                                                                          SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                          SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                          Summarytrue
                                                                                                                                          Requirements

                                                                                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          162. Immunization.programEligibility.text
                                                                                                                                          Definition

                                                                                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                                          ShortPlain text representation of the concept
                                                                                                                                          Comments

                                                                                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                                                                                          Control0..1
                                                                                                                                          Typestring
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                          Must Supporttrue
                                                                                                                                          Obligations
                                                                                                                                            ObligationsActorSource
                                                                                                                                            SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                            SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                            Summarytrue
                                                                                                                                            Requirements

                                                                                                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            164. Immunization.fundingSource
                                                                                                                                            Definition

                                                                                                                                            Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).

                                                                                                                                            ShortFunding source for the vaccine
                                                                                                                                            Control0..1
                                                                                                                                            BindingFor example codes, see ImmunizationFundingSource
                                                                                                                                            (example to http://hl7.org/fhir/ValueSet/immunization-funding-source|4.0.1)

                                                                                                                                            The source of funding used to purchase the vaccine administered.

                                                                                                                                            TypeCodeableConcept
                                                                                                                                            Is Modifierfalse
                                                                                                                                            Must Supporttrue
                                                                                                                                            Obligations
                                                                                                                                              ObligationsActorSource
                                                                                                                                              SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                              SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                              MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                              Summaryfalse
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              166. Immunization.fundingSource.id
                                                                                                                                              Definition

                                                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                              ShortUnique id for inter-element referencing
                                                                                                                                              Control0..1
                                                                                                                                              Typestring
                                                                                                                                              Is Modifierfalse
                                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                              Summaryfalse
                                                                                                                                              168. Immunization.fundingSource.extension
                                                                                                                                              Definition

                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                              ShortAdditional content defined by implementations
                                                                                                                                              Comments

                                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                              Control0..*
                                                                                                                                              TypeExtension
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Summaryfalse
                                                                                                                                              Alternate Namesextensions, user content
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                              SlicingThis element introduces a set of slices on Immunization.fundingSource.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                              • value @ url
                                                                                                                                              • 170. Immunization.fundingSource.coding
                                                                                                                                                Definition

                                                                                                                                                A reference to a code defined by a terminology system.

                                                                                                                                                ShortCode defined by a terminology system
                                                                                                                                                Comments

                                                                                                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                                                Control0..*
                                                                                                                                                TypeCoding
                                                                                                                                                Is Modifierfalse
                                                                                                                                                Must Supporttrue
                                                                                                                                                Obligations
                                                                                                                                                  ObligationsActorSource
                                                                                                                                                  SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                                  SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                                  MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                                  Summarytrue
                                                                                                                                                  Requirements

                                                                                                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  172. Immunization.fundingSource.text
                                                                                                                                                  Definition

                                                                                                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                                                  ShortPlain text representation of the concept
                                                                                                                                                  Comments

                                                                                                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                                                                                                  Control0..1
                                                                                                                                                  Typestring
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                  Must Supporttrue
                                                                                                                                                  Obligations
                                                                                                                                                    ObligationsActorSource
                                                                                                                                                    SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                                    SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                                    MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    174. Immunization.reaction
                                                                                                                                                    Definition

                                                                                                                                                    Categorical data indicating that an adverse event is associated in time to an immunization.

                                                                                                                                                    ShortDetails of a reaction that follows immunization
                                                                                                                                                    Comments

                                                                                                                                                    A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.

                                                                                                                                                    Control0..*
                                                                                                                                                    TypeBackboneElement
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    176. Immunization.reaction.id
                                                                                                                                                    Definition

                                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                                    Control0..1
                                                                                                                                                    Typestring
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                    Summaryfalse
                                                                                                                                                    178. Immunization.reaction.extension
                                                                                                                                                    Definition

                                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                                    Comments

                                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                    Control0..*
                                                                                                                                                    TypeExtension
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Alternate Namesextensions, user content
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                    180. Immunization.reaction.modifierExtension
                                                                                                                                                    Definition

                                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                    Comments

                                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                    Control0..*
                                                                                                                                                    TypeExtension
                                                                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                    182. Immunization.reaction.date
                                                                                                                                                    Definition

                                                                                                                                                    Date of reaction to the immunization.

                                                                                                                                                    ShortWhen reaction started
                                                                                                                                                    Control0..1
                                                                                                                                                    TypedateTime
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    184. Immunization.reaction.detail
                                                                                                                                                    Definition

                                                                                                                                                    Details of the reaction.

                                                                                                                                                    ShortAdditional information on reaction
                                                                                                                                                    Control0..1
                                                                                                                                                    TypeReference(Observation)
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    186. Immunization.reaction.reported
                                                                                                                                                    Definition

                                                                                                                                                    Self-reported indicator.

                                                                                                                                                    ShortIndicates self-reported reaction
                                                                                                                                                    Control0..1
                                                                                                                                                    Typeboolean
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    188. Immunization.protocolApplied
                                                                                                                                                    Definition

                                                                                                                                                    The protocol (set of recommendations) being followed by the provider who administered the dose.

                                                                                                                                                    ShortProtocol followed by the provider
                                                                                                                                                    Control0..*
                                                                                                                                                    TypeBackboneElement
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    190. Immunization.protocolApplied.id
                                                                                                                                                    Definition

                                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                                    Control0..1
                                                                                                                                                    Typestring
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                    Summaryfalse
                                                                                                                                                    192. Immunization.protocolApplied.extension
                                                                                                                                                    Definition

                                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                                    Comments

                                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                    Control0..*
                                                                                                                                                    TypeExtension
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Alternate Namesextensions, user content
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                    194. Immunization.protocolApplied.modifierExtension
                                                                                                                                                    Definition

                                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                    Comments

                                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                    Control0..*
                                                                                                                                                    TypeExtension
                                                                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                    196. Immunization.protocolApplied.series
                                                                                                                                                    Definition

                                                                                                                                                    One possible path to achieve presumed immunity against a disease - within the context of an authority.

                                                                                                                                                    ShortName of vaccine series
                                                                                                                                                    Control0..1
                                                                                                                                                    Typestring
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    198. Immunization.protocolApplied.authority
                                                                                                                                                    Definition

                                                                                                                                                    Indicates the authority who published the protocol (e.g. ACIP) that is being followed.

                                                                                                                                                    ShortWho is responsible for publishing the recommendations
                                                                                                                                                    Control0..1
                                                                                                                                                    TypeReference(Organization)
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    200. Immunization.protocolApplied.targetDisease
                                                                                                                                                    Definition

                                                                                                                                                    The vaccine preventable disease the dose is being administered against.

                                                                                                                                                    ShortVaccine preventatable disease being targetted
                                                                                                                                                    Control0..*
                                                                                                                                                    BindingFor example codes, see ImmunizationTargetDiseaseCodes
                                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/immunization-target-disease|4.0.1)

                                                                                                                                                    The vaccine preventable disease the dose is being administered for.

                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Must Supporttrue
                                                                                                                                                    Obligations
                                                                                                                                                      ObligationsActorSource
                                                                                                                                                      SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                                      SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                                      MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      202. Immunization.protocolApplied.targetDisease.id
                                                                                                                                                      Definition

                                                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                                                      Control0..1
                                                                                                                                                      Typestring
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                      Summaryfalse
                                                                                                                                                      204. Immunization.protocolApplied.targetDisease.extension
                                                                                                                                                      Definition

                                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                                      Comments

                                                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                      Control0..*
                                                                                                                                                      TypeExtension
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Alternate Namesextensions, user content
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                      SlicingThis element introduces a set of slices on Immunization.protocolApplied.targetDisease.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                      • value @ url
                                                                                                                                                      • 206. Immunization.protocolApplied.targetDisease.coding
                                                                                                                                                        Definition

                                                                                                                                                        A reference to a code defined by a terminology system.

                                                                                                                                                        ShortCode defined by a terminology system
                                                                                                                                                        Comments

                                                                                                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                                                        Control0..*
                                                                                                                                                        TypeCoding
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Must Supporttrue
                                                                                                                                                        Obligations
                                                                                                                                                          ObligationsActorSource
                                                                                                                                                          SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                                          SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                                          MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                                          Summarytrue
                                                                                                                                                          Requirements

                                                                                                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          208. Immunization.protocolApplied.targetDisease.text
                                                                                                                                                          Definition

                                                                                                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                                                          ShortPlain text representation of the concept
                                                                                                                                                          Comments

                                                                                                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                                                                                                          Control0..1
                                                                                                                                                          Typestring
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                          Must Supporttrue
                                                                                                                                                          Obligations
                                                                                                                                                            ObligationsActorSource
                                                                                                                                                            SHALL:handlePH Core Serverfrom PH Core Immunization
                                                                                                                                                            SHALL:handlePH Core Consumerfrom PH Core Immunization
                                                                                                                                                            MAY:able-to-populatePH Core Creatorfrom PH Core Immunization
                                                                                                                                                            Summarytrue
                                                                                                                                                            Requirements

                                                                                                                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            210. Immunization.protocolApplied.doseNumber[x]
                                                                                                                                                            Definition

                                                                                                                                                            Nominal position in a series.

                                                                                                                                                            ShortDose number within series
                                                                                                                                                            Comments

                                                                                                                                                            The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).

                                                                                                                                                            Control1..1
                                                                                                                                                            TypeChoice of: positiveInt, string
                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                            Summaryfalse
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            212. Immunization.protocolApplied.seriesDoses[x]
                                                                                                                                                            Definition

                                                                                                                                                            The recommended number of doses to achieve immunity.

                                                                                                                                                            ShortRecommended number of doses for immunity
                                                                                                                                                            Comments

                                                                                                                                                            The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).

                                                                                                                                                            Control0..1
                                                                                                                                                            TypeChoice of: positiveInt, string
                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                            Summaryfalse
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))