Generated Narrative: StructureDefinition vax-dose Name Flags Card. Type Description & Constraints Immunization 0..* Immunization Immunization event information #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:assessmentDate 0..1 dateTime Extension URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/assessment-date #xD; extension:inadvertentAdministration 0..1 boolean Inadvertent Administration Status URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/inadvertent-administration-status #xD; extension:validAgeStatus 0..1 boolean Valid Age Status URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/valid-age-status #xD; extension:validAgeReason 0..1 base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta Valid Age Reason URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/valid-age-reason Binding: Valid Age Reason (required) #xD; extension:preferredIntervalStatus 0..1 boolean Preferred Interval Status URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/preferred-interval-status #xD; extension:preferredIntervalReason 0..1 base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta Preferred Interval Reason URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/preferred-interval-reason Binding: Interval Reason (required) #xD; extension:allowedIntervalStatus 0..1 boolean Allowed Interval Status URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/allowed-interval-status #xD; extension:allowedIntervalReason 0..1 base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta Allowed Interval Reason URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/allowed-interval-reason Binding: Interval Reason (required) #xD; extension:vaccinationConflict 0..1 boolean Vaccination Conflict URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/vaccination-conflict #xD; extension:preferredVaccineStatus 0..1 boolean Preferred Vaccine Status URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/preferred-vaccine-status #xD; extension:preferredVaccineReason 0..1 base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta Preferred Vaccine Reason URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/preferred-vaccine-reason Binding: Reasons why certain doses are Preferred or Allowed doses (required) #xD; extension:allowedVaccineStatus 0..1 boolean Allowed Vaccine Status URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/allowed-vaccine-status #xD; extension:allowedVaccineReason 0..1 base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta Allowed Vaccine Reason URL: http://fhirfli.dev/fhir/ig/cicada/StructureDefinition/allowed-vaccine-reason Binding: Reasons why certain doses are Preferred or Allowed doses (required) #xD; status 1..1 code completed | entered-in-error | not-done Binding: Evaluation Status Value Set (required) #xD; statusReason 0..1 CodeableConcept Reason not done Binding: Evaluation Reason (extensible) #xD; vaccineCode 1..1 CodeableConcept Vaccine product administered Binding: VaccineCodesCvxMvx (required) #xD; Slices for occurrence[x] 1..1 dateTime Vaccine administration date Slice: Unordered, Open by type:$this #xD; occurrence[x]:occurrenceDateTime 1..1 dateTime Vaccine administration date #xD; subpotentReason 0..* CodeableConcept Reason for being subpotent Binding: ImmunizationSubpotentReason (required) #xD; protocolApplied 0..* BackboneElement Protocol followed by the provider Slice: Unordered, Open by pattern:doseNumberPositiveInt #xD; Documentation for this format
Detailed information about each vaccination dose.
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.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
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.
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.
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
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
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.
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
The date on which the vaccination assessment was made.
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
Indicates if the vaccine was administered inadvertently.
Indicates if the vaccine was administered at the correct age.
Captures the reason why the vaccine was administered at a particular age.
Indicates if the vaccine was administered at the preferred interval.
Captures the reason for the preferred interval between vaccine doses.
Captures the status of the allowed interval for vaccination.
Captures the reason for the allowed interval between vaccine doses.
Indicates any conflicts with other vaccinations.
Indicates if the vaccine administered is the preferred vaccine.
Captures the reason why a particular vaccine is preferred.
Indicates if the vaccine administered is allowed under certain conditions.
Captures the reason why a particular vaccine is allowed.
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).
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.
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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
A unique identifier assigned to this immunization record.
Indicates the current status of the immunization event.
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.
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
Indicates the reason the immunization event was not performed.
This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.
.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
Vaccine that was administered or was to be administered.
The patient who either received or did not receive the immunization.
The visit or admission or other contact between patient and health care provider the immunization was performed as part of.
Date vaccine administered or was to be administered.
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.
When the immunization was first captured in the subject's record
The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.
Indicates context the data was recorded in
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.
Reflects the “reliability” of the content.
immunization.uncertaintycode (if primary source=false, uncertainty=U)
Indicates the source of a secondarily reported record
The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.
Should not be populated if primarySource = True, not required even if primarySource = False.
The source of the data for a record which is not from a primary source.
.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
The service delivery location where the vaccine administration occurred.
RXA-27 (or RXA-11, deprecated as of v2.7)
Body site where vaccine was administered.
The site at which the vaccine was administered.
The path by which the vaccine product is taken into the body.
The route by which the vaccine was administered.
The quantity of vaccine product that was administered.
Indicates who performed the immunization event.
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Additional content defined by implementations
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.
Extensions that cannot be ignored even if unrecognized
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).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Describes the type of performance (e.g. ordering provider, administering provider, etc.).
The role a practitioner or organization plays in the immunization event.
Individual or organization who was performing
The practitioner or organization who performed the action.
When the individual practitioner who performed the action is known, it is best to send.
Extra information about the immunization that is not conveyed by the other attributes.
Reasons why the vaccine was administered.
The reason why a vaccine was administered.
Condition, Observation or DiagnosticReport that supports why the immunization was administered.
Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.
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.
By default, a dose should be considered to be potent.
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.
Reason why a dose is considered to be subpotent.
Educational material presented to patient
Educational material presented to the patient (or guardian) at the time of vaccine administration.
One of documentType or reference SHALL be present
documentType.exists() or reference.exists()
exists(f:documentType) or exists(f:reference)
Educational material document identifier
Identifier of the material presented to the patient.
Reference pointer to the educational material given to the patient if the information was on line.
Date the educational material was published.
Date the educational material was given to the patient.
Patient eligibility for a vaccination program
Indicates a patient's eligibility for a funding program.
The patient's eligibility for a vaccation program.
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).
The source of funding used to purchase the vaccine administered.
Details of a reaction that follows immunization
Categorical data indicating that an adverse event is associated in time to an immunization.
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.
OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all)
(HL7 v2 doesn't seem to provide for this)
.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
The protocol (set of recommendations) being followed by the provider who administered the dose.