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11.15 11.9 Resource ImmunizationRecommendation - Content

Public Health and Emergency Response Work Group Maturity Level : 1   Trial Use Security Category : Patient Compartments : Patient

A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.

STU Note: The Public Health work group wants to draw the attention of reviewers and implementers to the following issues for feedback:

ImmunizationRecommendation.recommendation is allowed to repeat, meaning that multiple recommendations for a given patient can be contained in a single resouce. This ensures that if the recommendations are interrelated, they are available in the same resource (for example, multiple doses of the same vaccine are recommended at different points in the future). Is the preference to allow repetitions of the recommendation backbone element or should the core resource constrain the cardinality to 1..1? The ImmunizationRecommendation resource can be thought of as a specialization of a generic recommendation (for a medication or a procedure, etc.). Is it better to have a single generic recommendation resource that is then profiled for use in specific domains (immunization recommendation, imaging recommendation, etc.) or individual, specific resources for each domain which require less profiling and may be easier for domain implementers to understand? Should the ImmunizationEvaluation resource be harmonized with the CDS Hooks project?

The ImmunizationRecommendation resource is intended to cover communication of a specified patient's immunization recommendations and status across all healthcare disciplines in all care settings and all regions. The set of customized (for the patient) recommendations is based on the comparison of the patient's immunization history with a set of published recommendations (protocols).

Additionally, the ImmunizationRecommendation resource is expected to cover key concepts related to the querying of a patient's immunization recommendations and status. This resource - through consultation with the Public Health work group - is believed to meet key use cases and information requirements as defined in the existing HL7 v3 POIZ domain and Immunization Domain Analysis Model.

This resource references the following resources:

  • Patient
  • Organization
  • Immunization
  • ImmunizationEvaluation

This resource is referenced by Appointment , CarePlan , DiagnosticReport , Encounter , MedicationRequest and Observation .

This resource implements the Request pattern.

Structure

Name Flags Card. Type Description & Constraints doco
. . ImmunizationRecommendation TU DomainResource Guidance or advice relating to an immunization
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Business identifier
. . . patient Σ 1..1 Reference ( Patient ) Who this profile is for
. . . date Σ 1..1 dateTime Date recommendation(s) created
. . . authority 0..1 Reference ( Organization ) Who is responsible for protocol
. . . recommendation Σ I 1..* BackboneElement Vaccine administration recommendations
+ Rule: One of vaccineCode or targetDisease SHALL be present
. . . . vaccineCode Σ 0..* CodeableConcept Vaccine or vaccine group recommendation applies to
Vaccine Administered Value Set ( Example )
. . . . targetDisease Σ 0..1 0..* CodeableConcept Disease to be immunized against
Immunization Recommendation Target Disease Codes ( Example )
. . . . contraindicatedVaccineCode Σ 0..* CodeableConcept Vaccine which is contraindicated to fulfill the recommendation
Vaccine Administered Value Set ( Example )
. . . . forecastStatus ?! Σ 1..1 CodeableConcept Vaccine recommendation status
Immunization Recommendation Status Codes ( Example )
. . . . forecastReason Σ 0..* CodeableConcept Vaccine administration status reason
Immunization Recommendation Reason Codes ( Example )
. . . . dateCriterion 0..* BackboneElement Dates governing proposed immunization
. . . . . code 1..1 CodeableConcept Type of date
Immunization Recommendation Date Criterion Codes ( Example )
. . . . . value 1..1 dateTime Recommended date
. . . . description 0..1 string Protocol details
. . . . series 0..1 string Name of vaccination series
. . . . doseNumber[x] Σ 0..1 Recommended dose number within series
. . . . . doseNumberPositiveInt white; #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class=hierarchy> white; #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class=hierarchy> white; #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class=hierarchy> positiveInt white; #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class=hierarchy>
. . . . . doseNumberString string
. . . . seriesDoses[x] 0..1 Recommended number of doses for immunity
. . . . . seriesDosesPositiveInt positiveInt
. . . . . seriesDosesString string
. . . . supportingImmunization 0..* Reference ( Immunization | ImmunizationEvaluation ) Past immunizations supporting recommendation
. . . . supportingPatientInformation 0..* Reference ( Any ) Patient observations supporting recommendation

doco Documentation for this format

UML Diagram ( Legend )

ImmunizationRecommendation ( DomainResource ) A unique identifier assigned to this particular recommendation record identifier : Identifier [0..*] The patient the recommendation(s) are for patient : Reference [1..1] « Patient » The date the immunization recommendation(s) were created date : dateTime [1..1] Indicates the authority who published the protocol (e.g. ACIP) authority : Reference [0..1] « Organization » Recommendation Vaccine(s) or vaccine group that pertain to the recommendation vaccineCode : CodeableConcept [0..*] « The type of vaccine administered administered. (Strength=Example) Vaccine Administered Value Set VaccineAdministeredValueSet ?? » The targeted disease for the recommendation targetDisease : CodeableConcept [0..1] [0..*] « The disease that the recommended vaccination targets targets. (Strength=Example) Immunization Recommendation T... ImmunizationRecommendationTar... ?? » Vaccine(s) which should not be used to fulfill the recommendation contraindicatedVaccineCode : CodeableConcept [0..*] « The type of vaccine administered administered. (Strength=Example) Vaccine Administered Value Set VaccineAdministeredValueSet ?? » Indicates the patient status with respect to the path to immunity for the target disease (this element modifies the meaning of other elements) forecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol protocol. (Strength=Example) Immunization Recommendation S... ImmunizationRecommendationSta... ?? » The reason for the assigned forecast status forecastReason : CodeableConcept [0..*] « The reason for the patient's status with respect to a vaccination protocol protocol. (Strength=Example) Immunization Recommendation R... ImmunizationRecommendationRea... ?? » Contains the description about the protocol under which the vaccine was administered description : string [0..1] One possible path to achieve presumed immunity against a disease - within the context of an authority series : string [0..1] Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose) doseNumber[x] : Type [0..1] « positiveInt | string » The recommended number of doses to achieve immunity seriesDoses[x] : Type [0..1] « positiveInt | string » Immunization event history and/or evaluation that supports the status and recommendation supportingImmunization : Reference [0..*] « Immunization | ImmunizationEvaluation » Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information supportingPatientInformation : Reference [0..*] « Any » DateCriterion Date classification of recommendation. For example, earliest date to give, latest date to give, etc code : CodeableConcept [1..1] « Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) etc.). (Strength=Example) Immunization Recommendation D... ImmunizationRecommendationDat... ?? » The date whose meaning is specified by dateCriterion.code value : dateTime [1..1] Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc dateCriterion [0..*] Vaccine administration recommendations recommendation [1..*]

XML Template

<ImmunizationRecommendation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <date value="[dateTime]"/><!-- 1..1 Date recommendation(s) created -->
 <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <vaccineCode><!-- 0..* CodeableConcept Vaccine  or vaccine group recommendation applies to --></vaccineCode>
  <</targetDisease>

  <targetDisease><!-- 0..* CodeableConcept Disease to be immunized against --></targetDisease>

  <contraindicatedVaccineCode><!-- 0..* CodeableConcept Vaccine which is contraindicated to fulfill the recommendation --></contraindicatedVaccineCode>
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine recommendation status --></forecastStatus>
  <forecastReason><!-- 0..* CodeableConcept Vaccine administration status reason --></forecastReason>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <description value="[string]"/><!-- 0..1 Protocol details -->
  <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  <doseNumber[x]><!-- 0..1 positiveInt|string Recommended dose number within series --></doseNumber[x]>
  <seriesDoses[x]><!-- 0..1 positiveInt|string Recommended number of doses for immunity --></seriesDoses[x]>
  <supportingImmunization><!-- 0..* Reference(Immunization|ImmunizationEvaluation) Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Any) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

JSON Template

{doco
  "resourceType" : "ImmunizationRecommendation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "patient" : { Reference(Patient) }, // R!  Who this profile is for
  "date" : "<dateTime>", // R!  Date recommendation(s) created
  "authority" : { Reference(Organization) }, // Who is responsible for protocol
  "recommendation" : [{ // R!  Vaccine administration recommendations
    "vaccineCode" : [{ CodeableConcept }], // Vaccine  or vaccine group recommendation applies to
    "

    "targetDisease" : [{ CodeableConcept }], // Disease to be immunized against

    "contraindicatedVaccineCode" : [{ CodeableConcept }], // Vaccine which is contraindicated to fulfill the recommendation
    "forecastStatus" : { CodeableConcept }, // R!  Vaccine recommendation status
    "forecastReason" : [{ CodeableConcept }], // Vaccine administration status reason
    "dateCriterion" : [{ // Dates governing proposed immunization
      "code" : { CodeableConcept }, // R!  Type of date
      "value" : "<dateTime>" // R!  Recommended date
    }],
    "description" : "<string>", // Protocol details
    "series" : "<string>", // Name of vaccination series
    // doseNumber[x]: Recommended dose number within series. One of these 2:
    "doseNumberPositiveInt" : "<positiveInt>",
    "doseNumberString" : "<string>",
    // seriesDoses[x]: Recommended number of doses for immunity. One of these 2:
    "seriesDosesPositiveInt" : "<positiveInt>",
    "seriesDosesString" : "<string>",
    "supportingImmunization" : [{ Reference(Immunization|ImmunizationEvaluation) }], // Past immunizations supporting recommendation
    "supportingPatientInformation" : [{ Reference(Any) }] // Patient observations supporting recommendation
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:ImmunizationRecommendation;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ImmunizationRecommendation.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:ImmunizationRecommendation.patient [ Reference(Patient) ]; # 1..1 Who this profile is for
  fhir:ImmunizationRecommendation.date [ dateTime ]; # 1..1 Date recommendation(s) created
  fhir:ImmunizationRecommendation.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol
  fhir:ImmunizationRecommendation.recommendation [ # 1..* Vaccine administration recommendations
    fhir:ImmunizationRecommendation.recommendation.vaccineCode [ CodeableConcept ], ... ; # 0..* Vaccine  or vaccine group recommendation applies to
    fhir:

    fhir:ImmunizationRecommendation.recommendation.targetDisease [ CodeableConcept ], ... ; # 0..* Disease to be immunized against

    fhir:ImmunizationRecommendation.recommendation.contraindicatedVaccineCode [ CodeableConcept ], ... ; # 0..* Vaccine which is contraindicated to fulfill the recommendation
    fhir:ImmunizationRecommendation.recommendation.forecastStatus [ CodeableConcept ]; # 1..1 Vaccine recommendation status
    fhir:ImmunizationRecommendation.recommendation.forecastReason [ CodeableConcept ], ... ; # 0..* Vaccine administration status reason
    fhir:ImmunizationRecommendation.recommendation.dateCriterion [ # 0..* Dates governing proposed immunization
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.code [ CodeableConcept ]; # 1..1 Type of date
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.value [ dateTime ]; # 1..1 Recommended date
    ], ...;
    fhir:ImmunizationRecommendation.recommendation.description [ string ]; # 0..1 Protocol details
    fhir:ImmunizationRecommendation.recommendation.series [ string ]; # 0..1 Name of vaccination series
    # ImmunizationRecommendation.recommendation.doseNumber[x] : 0..1 Recommended dose number within series. One of these 2
      fhir:ImmunizationRecommendation.recommendation.doseNumberPositiveInt [ positiveInt ]
      fhir:ImmunizationRecommendation.recommendation.doseNumberString [ string ]
    # ImmunizationRecommendation.recommendation.seriesDoses[x] : 0..1 Recommended number of doses for immunity. One of these 2
      fhir:ImmunizationRecommendation.recommendation.seriesDosesPositiveInt [ positiveInt ]
      fhir:ImmunizationRecommendation.recommendation.seriesDosesString [ string ]
    fhir:ImmunizationRecommendation.recommendation.supportingImmunization [ Reference(Immunization|ImmunizationEvaluation) ], ... ; # 0..* Past immunizations supporting recommendation
    fhir:ImmunizationRecommendation.recommendation.supportingPatientInformation [ Reference(Any) ], ... ; # 0..* Patient observations supporting recommendation
  ], ...;
]

Changes since R3

ImmunizationRecommendation.date Added Element ImmunizationRecommendation.authority Added Element ImmunizationRecommendation.recommendation.contraindicatedVaccineCode Added Element ImmunizationRecommendation.recommendation.forecastStatus Now marked as Modifier ImmunizationRecommendation.recommendation.forecastReason Added Element ImmunizationRecommendation.recommendation.description Added Element ImmunizationRecommendation.recommendation.series Added Element ImmunizationRecommendation.recommendation.doseNumber[x] Renamed from doseNumber to doseNumber[x] Add string ImmunizationRecommendation.recommendation.seriesDoses[x] Added Element ImmunizationRecommendation.recommendation.supportingImmunization Type changed from Reference(Immunization) to Reference(Immunization|ImmunizationEvaluation) ImmunizationRecommendation.recommendation.supportingPatientInformation Type changed from Reference(Observation|AllergyIntolerance) to Reference(Resource) ImmunizationRecommendation.recommendation.date deleted ImmunizationRecommendation.recommendation.protocol deleted
ImmunizationRecommendation
ImmunizationRecommendation.recommendation.vaccineCode ImmunizationRecommendation.recommendation.targetDisease
  • Max Cardinality changed from 1 to *

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. All tests pass round-trip testing and all r3 resources are valid.). Note: these have note yet been updated to be R3 to R4 valid.)

Structure

Name Flags Card. Type Description & Constraints doco
. . ImmunizationRecommendation TU DomainResource Guidance or advice relating to an immunization
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Business identifier
. . . patient Σ 1..1 Reference ( Patient ) Who this profile is for
. . . date Σ 1..1 dateTime Date recommendation(s) created
. . . authority 0..1 Reference ( Organization ) Who is responsible for protocol
. . . recommendation Σ I 1..* BackboneElement Vaccine administration recommendations
+ Rule: One of vaccineCode or targetDisease SHALL be present
. . . . vaccineCode Σ 0..* CodeableConcept Vaccine or vaccine group recommendation applies to
Vaccine Administered Value Set ( Example )
. . . . targetDisease Σ 0..1 0..* CodeableConcept Disease to be immunized against
Immunization Recommendation Target Disease Codes ( Example )
. . . . contraindicatedVaccineCode Σ 0..* CodeableConcept Vaccine which is contraindicated to fulfill the recommendation
Vaccine Administered Value Set ( Example )
. . . . forecastStatus ?! Σ 1..1 CodeableConcept Vaccine recommendation status
Immunization Recommendation Status Codes ( Example )
. . . . forecastReason Σ 0..* CodeableConcept Vaccine administration status reason
Immunization Recommendation Reason Codes ( Example )
. . . . dateCriterion 0..* BackboneElement Dates governing proposed immunization
. . . . . code 1..1 CodeableConcept Type of date
Immunization Recommendation Date Criterion Codes ( Example )
. . . . . value 1..1 dateTime Recommended date
. . . . description 0..1 string Protocol details
. . . . series 0..1 string Name of vaccination series
. . . . doseNumber[x] Σ 0..1 Recommended dose number within series
. . . . . doseNumberPositiveInt white; #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class=hierarchy> white; #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class=hierarchy> white; #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class=hierarchy> positiveInt white; #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class=hierarchy>
. . . . . doseNumberString string
. . . . seriesDoses[x] 0..1 Recommended number of doses for immunity
. . . . . seriesDosesPositiveInt positiveInt
. . . . . seriesDosesString string
. . . . supportingImmunization 0..* Reference ( Immunization | ImmunizationEvaluation ) Past immunizations supporting recommendation
. . . . supportingPatientInformation 0..* Reference ( Any ) Patient observations supporting recommendation

doco Documentation for this format

UML Diagram ( Legend )

ImmunizationRecommendation ( DomainResource ) A unique identifier assigned to this particular recommendation record identifier : Identifier [0..*] The patient the recommendation(s) are for patient : Reference [1..1] « Patient » The date the immunization recommendation(s) were created date : dateTime [1..1] Indicates the authority who published the protocol (e.g. ACIP) authority : Reference [0..1] « Organization » Recommendation Vaccine(s) or vaccine group that pertain to the recommendation vaccineCode : CodeableConcept [0..*] « The type of vaccine administered administered. (Strength=Example) Vaccine Administered Value Set VaccineAdministeredValueSet ?? » The targeted disease for the recommendation targetDisease : CodeableConcept [0..1] [0..*] « The disease that the recommended vaccination targets targets. (Strength=Example) Immunization Recommendation T... ImmunizationRecommendationTar... ?? » Vaccine(s) which should not be used to fulfill the recommendation contraindicatedVaccineCode : CodeableConcept [0..*] « The type of vaccine administered administered. (Strength=Example) Vaccine Administered Value Set VaccineAdministeredValueSet ?? » Indicates the patient status with respect to the path to immunity for the target disease (this element modifies the meaning of other elements) forecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol protocol. (Strength=Example) Immunization Recommendation S... ImmunizationRecommendationSta... ?? » The reason for the assigned forecast status forecastReason : CodeableConcept [0..*] « The reason for the patient's status with respect to a vaccination protocol protocol. (Strength=Example) Immunization Recommendation R... ImmunizationRecommendationRea... ?? » Contains the description about the protocol under which the vaccine was administered description : string [0..1] One possible path to achieve presumed immunity against a disease - within the context of an authority series : string [0..1] Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose) doseNumber[x] : Type [0..1] « positiveInt | string » The recommended number of doses to achieve immunity seriesDoses[x] : Type [0..1] « positiveInt | string » Immunization event history and/or evaluation that supports the status and recommendation supportingImmunization : Reference [0..*] « Immunization | ImmunizationEvaluation » Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information supportingPatientInformation : Reference [0..*] « Any » DateCriterion Date classification of recommendation. For example, earliest date to give, latest date to give, etc code : CodeableConcept [1..1] « Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) etc.). (Strength=Example) Immunization Recommendation D... ImmunizationRecommendationDat... ?? » The date whose meaning is specified by dateCriterion.code value : dateTime [1..1] Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc dateCriterion [0..*] Vaccine administration recommendations recommendation [1..*]

XML Template

<ImmunizationRecommendation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <date value="[dateTime]"/><!-- 1..1 Date recommendation(s) created -->
 <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <vaccineCode><!-- 0..* CodeableConcept Vaccine  or vaccine group recommendation applies to --></vaccineCode>
  <</targetDisease>

  <targetDisease><!-- 0..* CodeableConcept Disease to be immunized against --></targetDisease>

  <contraindicatedVaccineCode><!-- 0..* CodeableConcept Vaccine which is contraindicated to fulfill the recommendation --></contraindicatedVaccineCode>
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine recommendation status --></forecastStatus>
  <forecastReason><!-- 0..* CodeableConcept Vaccine administration status reason --></forecastReason>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <description value="[string]"/><!-- 0..1 Protocol details -->
  <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  <doseNumber[x]><!-- 0..1 positiveInt|string Recommended dose number within series --></doseNumber[x]>
  <seriesDoses[x]><!-- 0..1 positiveInt|string Recommended number of doses for immunity --></seriesDoses[x]>
  <supportingImmunization><!-- 0..* Reference(Immunization|ImmunizationEvaluation) Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Any) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

JSON Template

{doco
  "resourceType" : "ImmunizationRecommendation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "patient" : { Reference(Patient) }, // R!  Who this profile is for
  "date" : "<dateTime>", // R!  Date recommendation(s) created
  "authority" : { Reference(Organization) }, // Who is responsible for protocol
  "recommendation" : [{ // R!  Vaccine administration recommendations
    "vaccineCode" : [{ CodeableConcept }], // Vaccine  or vaccine group recommendation applies to
    "

    "targetDisease" : [{ CodeableConcept }], // Disease to be immunized against

    "contraindicatedVaccineCode" : [{ CodeableConcept }], // Vaccine which is contraindicated to fulfill the recommendation
    "forecastStatus" : { CodeableConcept }, // R!  Vaccine recommendation status
    "forecastReason" : [{ CodeableConcept }], // Vaccine administration status reason
    "dateCriterion" : [{ // Dates governing proposed immunization
      "code" : { CodeableConcept }, // R!  Type of date
      "value" : "<dateTime>" // R!  Recommended date
    }],
    "description" : "<string>", // Protocol details
    "series" : "<string>", // Name of vaccination series
    // doseNumber[x]: Recommended dose number within series. One of these 2:
    "doseNumberPositiveInt" : "<positiveInt>",
    "doseNumberString" : "<string>",
    // seriesDoses[x]: Recommended number of doses for immunity. One of these 2:
    "seriesDosesPositiveInt" : "<positiveInt>",
    "seriesDosesString" : "<string>",
    "supportingImmunization" : [{ Reference(Immunization|ImmunizationEvaluation) }], // Past immunizations supporting recommendation
    "supportingPatientInformation" : [{ Reference(Any) }] // Patient observations supporting recommendation
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:ImmunizationRecommendation;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ImmunizationRecommendation.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:ImmunizationRecommendation.patient [ Reference(Patient) ]; # 1..1 Who this profile is for
  fhir:ImmunizationRecommendation.date [ dateTime ]; # 1..1 Date recommendation(s) created
  fhir:ImmunizationRecommendation.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol
  fhir:ImmunizationRecommendation.recommendation [ # 1..* Vaccine administration recommendations
    fhir:ImmunizationRecommendation.recommendation.vaccineCode [ CodeableConcept ], ... ; # 0..* Vaccine  or vaccine group recommendation applies to
    fhir:

    fhir:ImmunizationRecommendation.recommendation.targetDisease [ CodeableConcept ], ... ; # 0..* Disease to be immunized against

    fhir:ImmunizationRecommendation.recommendation.contraindicatedVaccineCode [ CodeableConcept ], ... ; # 0..* Vaccine which is contraindicated to fulfill the recommendation
    fhir:ImmunizationRecommendation.recommendation.forecastStatus [ CodeableConcept ]; # 1..1 Vaccine recommendation status
    fhir:ImmunizationRecommendation.recommendation.forecastReason [ CodeableConcept ], ... ; # 0..* Vaccine administration status reason
    fhir:ImmunizationRecommendation.recommendation.dateCriterion [ # 0..* Dates governing proposed immunization
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.code [ CodeableConcept ]; # 1..1 Type of date
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.value [ dateTime ]; # 1..1 Recommended date
    ], ...;
    fhir:ImmunizationRecommendation.recommendation.description [ string ]; # 0..1 Protocol details
    fhir:ImmunizationRecommendation.recommendation.series [ string ]; # 0..1 Name of vaccination series
    # ImmunizationRecommendation.recommendation.doseNumber[x] : 0..1 Recommended dose number within series. One of these 2
      fhir:ImmunizationRecommendation.recommendation.doseNumberPositiveInt [ positiveInt ]
      fhir:ImmunizationRecommendation.recommendation.doseNumberString [ string ]
    # ImmunizationRecommendation.recommendation.seriesDoses[x] : 0..1 Recommended number of doses for immunity. One of these 2
      fhir:ImmunizationRecommendation.recommendation.seriesDosesPositiveInt [ positiveInt ]
      fhir:ImmunizationRecommendation.recommendation.seriesDosesString [ string ]
    fhir:ImmunizationRecommendation.recommendation.supportingImmunization [ Reference(Immunization|ImmunizationEvaluation) ], ... ; # 0..* Past immunizations supporting recommendation
    fhir:ImmunizationRecommendation.recommendation.supportingPatientInformation [ Reference(Any) ], ... ; # 0..* Patient observations supporting recommendation
  ], ...;
]

Changes since DSTU2 Release 3

ImmunizationRecommendation.date Added Element ImmunizationRecommendation.authority Added Element ImmunizationRecommendation.recommendation.contraindicatedVaccineCode Added Element ImmunizationRecommendation.recommendation.forecastStatus Now marked as Modifier ImmunizationRecommendation.recommendation.forecastReason Added Element ImmunizationRecommendation.recommendation.description Added Element ImmunizationRecommendation.recommendation.series Added Element ImmunizationRecommendation.recommendation.doseNumber[x] Renamed from doseNumber to doseNumber[x] Add string ImmunizationRecommendation.recommendation.seriesDoses[x] Added Element ImmunizationRecommendation.recommendation.supportingImmunization Type changed from Reference(Immunization) to Reference(Immunization|ImmunizationEvaluation) ImmunizationRecommendation.recommendation.supportingPatientInformation Type changed from Reference(Observation|AllergyIntolerance) to Reference(Resource) ImmunizationRecommendation.recommendation.date deleted ImmunizationRecommendation.recommendation.protocol deleted
ImmunizationRecommendation
ImmunizationRecommendation.recommendation.vaccineCode ImmunizationRecommendation.recommendation.targetDisease
  • Max Cardinality changed from 1 to *

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. All tests pass round-trip testing and all r3 resources are valid.). Note: these have note yet been updated to be R3 to R4 valid.)

 

Alternate See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis a

Path Definition Type Reference
ImmunizationRecommendation.recommendation.vaccineCode
ImmunizationRecommendation.recommendation.contraindicatedVaccineCode
The type of vaccine administered administered. Example Vaccine Administered Value Set VaccineAdministeredValueSet
ImmunizationRecommendation.recommendation.targetDisease The disease that the recommended vaccination targets targets. Example Immunization Recommendation Target Disease Codes ImmunizationRecommendationTargetDiseaseCodes
ImmunizationRecommendation.recommendation.forecastStatus The patient's status with respect to a vaccination protocol protocol. Example Immunization Recommendation Status Codes ImmunizationRecommendationStatusCodes
ImmunizationRecommendation.recommendation.forecastReason The reason for the patient's status with respect to a vaccination protocol protocol. Example Immunization Recommendation Reason Codes ImmunizationRecommendationReasonCodes
ImmunizationRecommendation.recommendation.dateCriterion.code Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) etc.). Example Immunization Recommendation Date Criterion Codes ImmunizationRecommendationDateCriterionCodes

id Level Location Description Expression
imr-1 : On ImmunizationRecommendation.recommendation: Rule ImmunizationRecommendation.recommendation One of vaccineCode or targetDisease SHALL be present ( expression on ImmunizationRecommendation.recommendation: vaccineCode.exists() or targetDisease.exists() )

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
date date Date recommendation(s) created ImmunizationRecommendation.date
dose-number number Recommended dose number within series ImmunizationRecommendation.recommendation.doseNumber dose-sequence number Recommended number of doses for immunity ImmunizationRecommendation.recommendation.seriesDoses identifier token Business identifier ImmunizationRecommendation.identifier
information reference Patient observations supporting recommendation ImmunizationRecommendation.recommendation.supportingPatientInformation
(Any)
patient reference Who this profile is for ImmunizationRecommendation.patient
( Patient )
status token Vaccine recommendation status ImmunizationRecommendation.recommendation.forecastStatus
support reference Past immunizations supporting recommendation ImmunizationRecommendation.recommendation.supportingImmunization
( Immunization , ImmunizationEvaluation )
target-disease token Disease to be immunized against ImmunizationRecommendation.recommendation.targetDisease
vaccine-type token Vaccine or vaccine group recommendation applies to ImmunizationRecommendation.recommendation.vaccineCode