HL7 Europe Base and Core FHIR IG
2.0.0 - trial-use 150

HL7 Europe Base and Core FHIR IG, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/patrick-werner/base/ and changes regularly. See the Directory of published versions

## Resource Profile: Immunization (EU core)

Official URL: http://hl7.eu/fhir/base/StructureDefinition/immunization-eu-core | Version: 2.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: ImmunizationEuCore
Copyright/Legal: Copyright HL7 Europe. Licensed under creative commons public domain (CC0 1.0).

This profile introduces essential constraints and extensions for the Immunization resource that apply across multiple use cases.

This profile constrains the Immunization resource for the purpose of this guide.

Usages:

- Examples for this Profile: Immunization/immunization-eu-core-example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization event information
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the immunization content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:administeredProduct |  | 0..1 | (Complex) | R5: Product that was administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:_datatype |  | 1..1 | Extension | DataType slice for a FHIR R5 `CodeableReference` value Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/_datatype"
value[x] |  | 1..1 | string | Value of extension Fixed Value: CodeableReference
extension:concept |  | 0..1 | Extension | R5: Reference to a concept (by class) Constraints: ext-1
url |  | 1..1 | uri | "concept"
extension:reference |  | 0..1 | Extension | Extension Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reference"
value[x] |  | 0..1 | Reference(Medication (EU core)) | Reference to a resource (by instance)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct"
extension:informationSource |  | 0..1 | (Complex) | R5: Indicates the source of a reported record (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:_datatype |  | 1..1 | Extension | DataType slice for a FHIR R5 `CodeableReference` value Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/_datatype"
value[x] |  | 1..1 | string | Value of extension Fixed Value: CodeableReference
extension:concept |  | 0..1 | Extension | R5: Reference to a concept (by class) Constraints: ext-1
url |  | 1..1 | uri | "concept"
extension:reference |  | 0..1 | Extension | Extension Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reference"
value[x] |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | RelatedPerson | Organization (EU core)) | Reference to a resource (by instance)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Identifier of the immunization
status | ?!Σ | 1..1 | code | Immunization status. Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason |  | 0..1 | CodeableConcept | Reason for not performing. Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | Σ | 1..1 | CodeableConcept | Vaccine product administered Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | Preferred | For when WHO ATC code system is preferred
eHDSI Vaccine | Preferred | For EU cross-border use
patient | Σ | 1..1 | Reference(Patient (EU core)) | Who was immunized
Slices for occurrence[x] | Σ | 1..1 |  | Date of vaccination Slice: Unordered, Open by type:$this
occurrenceDateTime |  |  | dateTime |
occurrenceString |  |  | string |
occurrence[x]:occurrenceDateTime | Σ | 0..1 | dateTime | Vaccine administration date
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfLife |  | 0..1 | (Complex) | Many: Periods of Life URL: http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Periods of Life (preferred)
location |  | 0..1 | Reference(Location (EU core)) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer/MAH
lotNumber |  | 0..1 | string | Batch/lot number
Slices for performer | Σ | 0..* | BackboneElement | Who performed event Slice: Unordered, Open by value:$this.function
performer:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Individual or organization who was performing
performer:administeringCentreOrHp | Σ | 0..* | BackboneElement | Administering centre
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0443
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: AP
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
actor | Σ | 1..1 | Reference(Organization (EU core) | PractitionerRole (EU core) | Practitioner (EU core)) | Individual or organization who was performing
reasonCode |  | 0..* | CodeableConcept | Reasons for the administration. Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | ⏿2.0.0 | tx.hl7europe.eu
Immunization.occurrence[x]:occurrenceDateTime.​extension:periodOfLife.​value[x] | Base | preferred | Periods of Life | 📦2.0.0 | This IG
Immunization.performer:administeringCentreOrHp.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.reasonCode | Base | example | Immunization Reason Codes | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from Immunization

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization event information
language |  | 0..1 | code | Language of the immunization content
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:administeredProduct |  | 0..1 | (Complex) | R5: Product that was administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct
Slices for extension |  |  |  | Content/Rules for all slices
extension:reference |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
value[x] |  | 0..1 | Reference(Medication (EU core)) | Reference to a resource (by instance)
extension:informationSource |  | 0..1 | (Complex) | R5: Indicates the source of a reported record (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource
Slices for extension |  |  |  | Content/Rules for all slices
extension:reference |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
value[x] |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | RelatedPerson | Organization (EU core)) | Reference to a resource (by instance)
identifier |  | 0..* | Identifier | Identifier of the immunization
status |  | 1..1 | code | Immunization status.
statusReason |  | 0..1 | CodeableConcept | Reason for not performing.
vaccineCode |  | 1..1 | CodeableConcept | Vaccine product administered Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | Preferred | For when WHO ATC code system is preferred
eHDSI Vaccine | Preferred | For EU cross-border use
patient |  | 1..1 | Reference(Patient (EU core)) | Who was immunized
Slices for occurrence[x] |  | 1..1 | dateTime, string | Date of vaccination Slice: Unordered, Open by type:$this
occurrence[x]:occurrenceDateTime |  | 0..1 | dateTime | Vaccine administration date
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfLife |  | 0..1 | (Complex) | Many: Periods of Life URL: http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Periods of Life (preferred)
location |  | 0..1 | Reference(Location (EU core)) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer/MAH
lotNumber |  | 0..1 | string | Batch/lot number
Slices for performer |  | 0..* | BackboneElement | Who performed event Slice: Unordered, Open by value:$this.function
performer:administeringCentreOrHp |  | 0..* | BackboneElement | Administering centre
function |  | 0..1 | CodeableConcept | What type of performance was done Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0443
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: AP
actor |  | 1..1 | Reference(Organization (EU core) | PractitionerRole (EU core) | Practitioner (EU core)) | Individual or organization who was performing
note |  |  |  |
text |  | 1..1 | markdown | Additional notes about the immunization
reasonCode |  | 0..* | CodeableConcept | Reasons for the administration.
protocolApplied |  |  |  |
targetDisease |  | 0..* | CodeableConcept | Vaccine preventatable disease being targetted Binding: Vaccine Target Diseases - IPS (preferred): The diseases against which the patient has been immunised
Additional Bindings | Purpose | Documentation
eHDSI Illness and Disorder | Preferred | For when WHO ATC code system is preferred
doseNumber[x] |  | 1..1 | positiveInt, string | Dose Number
seriesDoses[x] |  | 0..1 | positiveInt, string | Number of doses
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | ⏿2.0.0 | tx.hl7europe.eu
Immunization.occurrence[x]:occurrenceDateTime.​extension:periodOfLife.​value[x] | Base | preferred | Periods of Life | 📦2.0.0 | This IG
Immunization.protocolApplied.​targetDisease | Base | preferred | Vaccine Target Diseases - IPS | ⏿2.0.0 | tx.hl7europe.eu

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization event information
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the immunization content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:administeredProduct |  | 0..1 | (Complex) | R5: Product that was administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:_datatype |  | 1..1 | Extension | DataType slice for a FHIR R5 `CodeableReference` value Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/_datatype"
value[x] |  | 1..1 | string | Value of extension Fixed Value: CodeableReference
extension:concept |  | 0..1 | Extension | R5: Reference to a concept (by class) Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "concept"
value[x] |  | 0..1 | CodeableConcept | Reference to a concept (by class)
extension:reference |  | 0..1 | Extension | Extension Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reference"
value[x] |  | 0..1 | Reference(Medication (EU core)) | Reference to a resource (by instance)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct"
extension:informationSource |  | 0..1 | (Complex) | R5: Indicates the source of a reported record (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:_datatype |  | 1..1 | Extension | DataType slice for a FHIR R5 `CodeableReference` value Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/_datatype"
value[x] |  | 1..1 | string | Value of extension Fixed Value: CodeableReference
extension:concept |  | 0..1 | Extension | R5: Reference to a concept (by class) Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "concept"
value[x] |  | 0..1 | CodeableConcept | Reference to a concept (by class) Binding: ImmunizationOriginCodes (preferred)
extension:reference |  | 0..1 | Extension | Extension Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reference"
value[x] |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | RelatedPerson | Organization (EU core)) | Reference to a resource (by instance)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Identifier of the immunization
status | ?!Σ | 1..1 | code | Immunization status. Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason |  | 0..1 | CodeableConcept | Reason for not performing. Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | Σ | 1..1 | CodeableConcept | Vaccine product administered Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | Preferred | For when WHO ATC code system is preferred
eHDSI Vaccine | Preferred | For EU cross-border use
patient | Σ | 1..1 | Reference(Patient (EU core)) | Who was immunized
encounter |  | 0..1 | Reference(Encounter) | Encounter immunization was part of
Slices for occurrence[x] | Σ | 1..1 |  | Date of vaccination Slice: Unordered, Open by type:$this
occurrenceDateTime |  |  | dateTime |
occurrenceString |  |  | string |
occurrence[x]:occurrenceDateTime | Σ | 0..1 | dateTime | Vaccine administration date
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfLife |  | 0..1 | (Complex) | Many: Periods of Life URL: http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Periods of Life (preferred)
value |  | 0..1 | dateTime | Primitive value for dateTime
recorded |  | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | Σ | 0..1 | boolean | Indicates context the data was recorded in
reportOrigin |  | 0..1 | CodeableConcept | Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
location |  | 0..1 | Reference(Location (EU core)) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer/MAH
lotNumber |  | 0..1 | string | Batch/lot number
expirationDate |  | 0..1 | date | Vaccine expiration date
site |  | 0..1 | CodeableConcept | Body site vaccine was administered Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.
route |  | 0..1 | CodeableConcept | How vaccine entered body Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.
doseQuantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of vaccine administered
Slices for performer | Σ | 0..* | BackboneElement | Who performed event Slice: Unordered, Open by value:$this.function
performer:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Individual or organization who was performing
performer:administeringCentreOrHp | Σ | 0..* | BackboneElement | Administering centre
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0443
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: AP
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
actor | Σ | 1..1 | Reference(Organization (EU core) | PractitionerRole (EU core) | Practitioner (EU core)) | Individual or organization who was performing
note | Σ | 0..* | Annotation | Additional immunization notes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | Additional notes about the immunization
reasonCode |  | 0..* | CodeableConcept | Reasons for the administration. Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Why immunization occurred
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
subpotentReason |  | 0..* | CodeableConcept | Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
education | C | 0..* | BackboneElement | Educational material presented to patient Constraints: imm-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
documentType |  | 0..1 | string | Educational material document identifier
reference |  | 0..1 | uri | Educational material reference pointer
publicationDate |  | 0..1 | dateTime | Educational material publication date
presentationDate |  | 0..1 | dateTime | Educational material presentation date
programEligibility |  | 0..* | CodeableConcept | Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
fundingSource |  | 0..1 | CodeableConcept | Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
reaction |  | 0..* | BackboneElement | Details of a reaction that follows immunization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
date |  | 0..1 | dateTime | When reaction started
detail |  | 0..1 | Reference(Observation) | Additional information on reaction
reported |  | 0..1 | boolean | Indicates self-reported reaction
protocolApplied |  | 0..* | BackboneElement | Protocol followed by the provider
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
series |  | 0..1 | string | Name of vaccine series
authority |  | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations
targetDisease |  | 0..* | CodeableConcept | Vaccine preventatable disease being targetted Binding: Vaccine Target Diseases - IPS (preferred): The diseases against which the patient has been immunised
Additional Bindings | Purpose | Documentation
eHDSI Illness and Disorder | Preferred | For when WHO ATC code system is preferred
doseNumber[x] |  | 1..1 |  | Dose Number
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
seriesDoses[x] |  | 0..1 |  | Number of doses
seriesDosesPositiveInt |  |  | positiveInt |
seriesDosesString |  |  | string |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Immunization.extension:informationSource.​extension:concept.value[x] | Base | preferred | Immunization Origin Codes | 📍4.0.1 | FHIR Std.
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | ⏿2.0.0 | tx.hl7europe.eu
Immunization.occurrence[x]:occurrenceDateTime.​extension:periodOfLife.​value[x] | Base | preferred | Periods of Life | 📦2.0.0 | This IG
Immunization.reportOrigin | Base | example | Immunization Origin Codes | 📍4.0.1 | FHIR Std.
Immunization.site | Base | example | Codes for Immunization Site of Administration | 📍4.0.1 | FHIR Std.
Immunization.route | Base | example | Immunization Route Codes | 📍4.0.1 | FHIR Std.
Immunization.performer.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.performer:administeringCentreOrHp.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.reasonCode | Base | example | Immunization Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.subpotentReason | Base | example | Immunization Subpotent Reason | 📍4.0.1 | FHIR Std.
Immunization.programEligibility | Base | example | Immunization Program Eligibility | 📍4.0.1 | FHIR Std.
Immunization.fundingSource | Base | example | Immunization Funding Source | 📍4.0.1 | FHIR Std.
Immunization.protocolApplied.​targetDisease | Base | preferred | Vaccine Target Diseases - IPS | ⏿2.0.0 | tx.hl7europe.eu

#### Constraints

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

This structure is derived from Immunization

Summary

Prohibited: 2 elements

Structures

This structure refers to these other structures:

- Medication (EU core) (http://hl7.eu/fhir/base/StructureDefinition/medication-eu-core)
- Patient (EU core) (http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core)
- Practitioner (EU core) (http://hl7.eu/fhir/base/StructureDefinition/practitioner-eu-core)
- PractitionerRole (EU core) (http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu-core)
- Organization (EU core) (http://hl7.eu/fhir/base/StructureDefinition/organization-eu-core)
- Location (EU core) (http://hl7.eu/fhir/base/StructureDefinition/location-eu-core)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource
- http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Immunization.occurrence[x]
- The element 1 is sliced based on the value of Immunization.performer

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization event information
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the immunization content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:administeredProduct |  | 0..1 | (Complex) | R5: Product that was administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:_datatype |  | 1..1 | Extension | DataType slice for a FHIR R5 `CodeableReference` value Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/_datatype"
value[x] |  | 1..1 | string | Value of extension Fixed Value: CodeableReference
extension:concept |  | 0..1 | Extension | R5: Reference to a concept (by class) Constraints: ext-1
url |  | 1..1 | uri | "concept"
extension:reference |  | 0..1 | Extension | Extension Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reference"
value[x] |  | 0..1 | Reference(Medication (EU core)) | Reference to a resource (by instance)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct"
extension:informationSource |  | 0..1 | (Complex) | R5: Indicates the source of a reported record (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:_datatype |  | 1..1 | Extension | DataType slice for a FHIR R5 `CodeableReference` value Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/_datatype"
value[x] |  | 1..1 | string | Value of extension Fixed Value: CodeableReference
extension:concept |  | 0..1 | Extension | R5: Reference to a concept (by class) Constraints: ext-1
url |  | 1..1 | uri | "concept"
extension:reference |  | 0..1 | Extension | Extension Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reference"
value[x] |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | RelatedPerson | Organization (EU core)) | Reference to a resource (by instance)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Identifier of the immunization
status | ?!Σ | 1..1 | code | Immunization status. Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason |  | 0..1 | CodeableConcept | Reason for not performing. Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | Σ | 1..1 | CodeableConcept | Vaccine product administered Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | Preferred | For when WHO ATC code system is preferred
eHDSI Vaccine | Preferred | For EU cross-border use
patient | Σ | 1..1 | Reference(Patient (EU core)) | Who was immunized
Slices for occurrence[x] | Σ | 1..1 |  | Date of vaccination Slice: Unordered, Open by type:$this
occurrenceDateTime |  |  | dateTime |
occurrenceString |  |  | string |
occurrence[x]:occurrenceDateTime | Σ | 0..1 | dateTime | Vaccine administration date
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfLife |  | 0..1 | (Complex) | Many: Periods of Life URL: http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Periods of Life (preferred)
location |  | 0..1 | Reference(Location (EU core)) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer/MAH
lotNumber |  | 0..1 | string | Batch/lot number
Slices for performer | Σ | 0..* | BackboneElement | Who performed event Slice: Unordered, Open by value:$this.function
performer:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Individual or organization who was performing
performer:administeringCentreOrHp | Σ | 0..* | BackboneElement | Administering centre
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0443
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: AP
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
actor | Σ | 1..1 | Reference(Organization (EU core) | PractitionerRole (EU core) | Practitioner (EU core)) | Individual or organization who was performing
reasonCode |  | 0..* | CodeableConcept | Reasons for the administration. Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | ⏿2.0.0 | tx.hl7europe.eu
Immunization.occurrence[x]:occurrenceDateTime.​extension:periodOfLife.​value[x] | Base | preferred | Periods of Life | 📦2.0.0 | This IG
Immunization.performer:administeringCentreOrHp.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.reasonCode | Base | example | Immunization Reason Codes | 📍4.0.1 | FHIR Std.

#### Constraints

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

Differential View

This structure is derived from Immunization

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization event information
language |  | 0..1 | code | Language of the immunization content
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:administeredProduct |  | 0..1 | (Complex) | R5: Product that was administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct
Slices for extension |  |  |  | Content/Rules for all slices
extension:reference |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
value[x] |  | 0..1 | Reference(Medication (EU core)) | Reference to a resource (by instance)
extension:informationSource |  | 0..1 | (Complex) | R5: Indicates the source of a reported record (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource
Slices for extension |  |  |  | Content/Rules for all slices
extension:reference |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
value[x] |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | RelatedPerson | Organization (EU core)) | Reference to a resource (by instance)
identifier |  | 0..* | Identifier | Identifier of the immunization
status |  | 1..1 | code | Immunization status.
statusReason |  | 0..1 | CodeableConcept | Reason for not performing.
vaccineCode |  | 1..1 | CodeableConcept | Vaccine product administered Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | Preferred | For when WHO ATC code system is preferred
eHDSI Vaccine | Preferred | For EU cross-border use
patient |  | 1..1 | Reference(Patient (EU core)) | Who was immunized
Slices for occurrence[x] |  | 1..1 | dateTime, string | Date of vaccination Slice: Unordered, Open by type:$this
occurrence[x]:occurrenceDateTime |  | 0..1 | dateTime | Vaccine administration date
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfLife |  | 0..1 | (Complex) | Many: Periods of Life URL: http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Periods of Life (preferred)
location |  | 0..1 | Reference(Location (EU core)) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer/MAH
lotNumber |  | 0..1 | string | Batch/lot number
Slices for performer |  | 0..* | BackboneElement | Who performed event Slice: Unordered, Open by value:$this.function
performer:administeringCentreOrHp |  | 0..* | BackboneElement | Administering centre
function |  | 0..1 | CodeableConcept | What type of performance was done Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0443
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: AP
actor |  | 1..1 | Reference(Organization (EU core) | PractitionerRole (EU core) | Practitioner (EU core)) | Individual or organization who was performing
note |  |  |  |
text |  | 1..1 | markdown | Additional notes about the immunization
reasonCode |  | 0..* | CodeableConcept | Reasons for the administration.
protocolApplied |  |  |  |
targetDisease |  | 0..* | CodeableConcept | Vaccine preventatable disease being targetted Binding: Vaccine Target Diseases - IPS (preferred): The diseases against which the patient has been immunised
Additional Bindings | Purpose | Documentation
eHDSI Illness and Disorder | Preferred | For when WHO ATC code system is preferred
doseNumber[x] |  | 1..1 | positiveInt, string | Dose Number
seriesDoses[x] |  | 0..1 | positiveInt, string | Number of doses
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | ⏿2.0.0 | tx.hl7europe.eu
Immunization.occurrence[x]:occurrenceDateTime.​extension:periodOfLife.​value[x] | Base | preferred | Periods of Life | 📦2.0.0 | This IG
Immunization.protocolApplied.​targetDisease | Base | preferred | Vaccine Target Diseases - IPS | ⏿2.0.0 | tx.hl7europe.eu

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | Immunization event information
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the immunization content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:administeredProduct |  | 0..1 | (Complex) | R5: Product that was administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:_datatype |  | 1..1 | Extension | DataType slice for a FHIR R5 `CodeableReference` value Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/_datatype"
value[x] |  | 1..1 | string | Value of extension Fixed Value: CodeableReference
extension:concept |  | 0..1 | Extension | R5: Reference to a concept (by class) Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "concept"
value[x] |  | 0..1 | CodeableConcept | Reference to a concept (by class)
extension:reference |  | 0..1 | Extension | Extension Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reference"
value[x] |  | 0..1 | Reference(Medication (EU core)) | Reference to a resource (by instance)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct"
extension:informationSource |  | 0..1 | (Complex) | R5: Indicates the source of a reported record (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:_datatype |  | 1..1 | Extension | DataType slice for a FHIR R5 `CodeableReference` value Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/_datatype"
value[x] |  | 1..1 | string | Value of extension Fixed Value: CodeableReference
extension:concept |  | 0..1 | Extension | R5: Reference to a concept (by class) Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "concept"
value[x] |  | 0..1 | CodeableConcept | Reference to a concept (by class) Binding: ImmunizationOriginCodes (preferred)
extension:reference |  | 0..1 | Extension | Extension Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reference"
value[x] |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | RelatedPerson | Organization (EU core)) | Reference to a resource (by instance)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Identifier of the immunization
status | ?!Σ | 1..1 | code | Immunization status. Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason |  | 0..1 | CodeableConcept | Reason for not performing. Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | Σ | 1..1 | CodeableConcept | Vaccine product administered Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.
Additional Bindings | Purpose | Documentation
Vaccines WHO ATC - IPS | Preferred | For when WHO ATC code system is preferred
eHDSI Vaccine | Preferred | For EU cross-border use
patient | Σ | 1..1 | Reference(Patient (EU core)) | Who was immunized
encounter |  | 0..1 | Reference(Encounter) | Encounter immunization was part of
Slices for occurrence[x] | Σ | 1..1 |  | Date of vaccination Slice: Unordered, Open by type:$this
occurrenceDateTime |  |  | dateTime |
occurrenceString |  |  | string |
occurrence[x]:occurrenceDateTime | Σ | 0..1 | dateTime | Vaccine administration date
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfLife |  | 0..1 | (Complex) | Many: Periods of Life URL: http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Periods of Life (preferred)
value |  | 0..1 | dateTime | Primitive value for dateTime
recorded |  | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | Σ | 0..1 | boolean | Indicates context the data was recorded in
reportOrigin |  | 0..1 | CodeableConcept | Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
location |  | 0..1 | Reference(Location (EU core)) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer/MAH
lotNumber |  | 0..1 | string | Batch/lot number
expirationDate |  | 0..1 | date | Vaccine expiration date
site |  | 0..1 | CodeableConcept | Body site vaccine was administered Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.
route |  | 0..1 | CodeableConcept | How vaccine entered body Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.
doseQuantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of vaccine administered
Slices for performer | Σ | 0..* | BackboneElement | Who performed event Slice: Unordered, Open by value:$this.function
performer:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Individual or organization who was performing
performer:administeringCentreOrHp | Σ | 0..* | BackboneElement | Administering centre
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0443
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: AP
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
actor | Σ | 1..1 | Reference(Organization (EU core) | PractitionerRole (EU core) | Practitioner (EU core)) | Individual or organization who was performing
note | Σ | 0..* | Annotation | Additional immunization notes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | Additional notes about the immunization
reasonCode |  | 0..* | CodeableConcept | Reasons for the administration. Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Why immunization occurred
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
subpotentReason |  | 0..* | CodeableConcept | Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
education | C | 0..* | BackboneElement | Educational material presented to patient Constraints: imm-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
documentType |  | 0..1 | string | Educational material document identifier
reference |  | 0..1 | uri | Educational material reference pointer
publicationDate |  | 0..1 | dateTime | Educational material publication date
presentationDate |  | 0..1 | dateTime | Educational material presentation date
programEligibility |  | 0..* | CodeableConcept | Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
fundingSource |  | 0..1 | CodeableConcept | Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
reaction |  | 0..* | BackboneElement | Details of a reaction that follows immunization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
date |  | 0..1 | dateTime | When reaction started
detail |  | 0..1 | Reference(Observation) | Additional information on reaction
reported |  | 0..1 | boolean | Indicates self-reported reaction
protocolApplied |  | 0..* | BackboneElement | Protocol followed by the provider
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
series |  | 0..1 | string | Name of vaccine series
authority |  | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations
targetDisease |  | 0..* | CodeableConcept | Vaccine preventatable disease being targetted Binding: Vaccine Target Diseases - IPS (preferred): The diseases against which the patient has been immunised
Additional Bindings | Purpose | Documentation
eHDSI Illness and Disorder | Preferred | For when WHO ATC code system is preferred
doseNumber[x] |  | 1..1 |  | Dose Number
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
seriesDoses[x] |  | 0..1 |  | Number of doses
seriesDosesPositiveInt |  |  | positiveInt |
seriesDosesString |  |  | string |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Immunization.extension:informationSource.​extension:concept.value[x] | Base | preferred | Immunization Origin Codes | 📍4.0.1 | FHIR Std.
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | preferred | Vaccines - IPS | ⏿2.0.0 | tx.hl7europe.eu
Immunization.occurrence[x]:occurrenceDateTime.​extension:periodOfLife.​value[x] | Base | preferred | Periods of Life | 📦2.0.0 | This IG
Immunization.reportOrigin | Base | example | Immunization Origin Codes | 📍4.0.1 | FHIR Std.
Immunization.site | Base | example | Codes for Immunization Site of Administration | 📍4.0.1 | FHIR Std.
Immunization.route | Base | example | Immunization Route Codes | 📍4.0.1 | FHIR Std.
Immunization.performer.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.performer:administeringCentreOrHp.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.reasonCode | Base | example | Immunization Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.subpotentReason | Base | example | Immunization Subpotent Reason | 📍4.0.1 | FHIR Std.
Immunization.programEligibility | Base | example | Immunization Program Eligibility | 📍4.0.1 | FHIR Std.
Immunization.fundingSource | Base | example | Immunization Funding Source | 📍4.0.1 | FHIR Std.
Immunization.protocolApplied.​targetDisease | Base | preferred | Vaccine Target Diseases - IPS | ⏿2.0.0 | tx.hl7europe.eu

#### Constraints

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

This structure is derived from Immunization

Summary

Prohibited: 2 elements

Structures

This structure refers to these other structures:

- Medication (EU core) (http://hl7.eu/fhir/base/StructureDefinition/medication-eu-core)
- Patient (EU core) (http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core)
- Practitioner (EU core) (http://hl7.eu/fhir/base/StructureDefinition/practitioner-eu-core)
- PractitionerRole (EU core) (http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu-core)
- Organization (EU core) (http://hl7.eu/fhir/base/StructureDefinition/organization-eu-core)
- Location (EU core) (http://hl7.eu/fhir/base/StructureDefinition/location-eu-core)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.informationSource
- http://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Immunization.occurrence[x]
- The element 1 is sliced based on the value of Immunization.performer

Maturity: 2

Other representations of profile: CSV, Excel, Schematron