Name	Flags	Card.	Type	Description & Constraints
Immunization	C	0..*	USCoreImmunizationProfile(5.0.1)	Immunization event information This profile also complies with the profiles US Core Immunization Profile (6.1.0) and US Core Immunization Profile (7.0.0) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management us-core-5: SHOULD have a translation to the NDC value set
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣC	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required) ele-1: All FHIR elements must have a @value or children ii-24-297: If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed ii-24-298: If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record ii-24-299: If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done
statusReason	SC	0..1	CodeableConcept	Reason not done Binding: immunizationStatusReason FHIR (required): see mapping VF_immunizationStatusReason ele-1: All FHIR elements must have a @value or children ii-24-527: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason
vaccineCode	SΣC	1..1	CodeableConcept	Vaccine Product Type (bind to CVX) Binding: inferredCVX FHIR (required): see mapping VF_inferredCVX ele-1: All FHIR elements must have a @value or children ii-24-528: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this ele-1: All FHIR elements must have a @value or children
coding:va-cvx	Σ	0..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	SΣC	0..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children ii-24-332-2: If not null then fixed value http://hl7.org/fhir/sid/cvx
code	SΣC	0..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children ii-24-332: If not null then source value from (9000010.11-.01 > 9999999.14-.03)
coding:va-ndc	Σ	0..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	SΣ	0..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Required Pattern: http://hl7.org/fhir/sid/ndc
code	SΣ	0..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children
text	SΣC	0..1	string	Plain text representation of the concept ele-1: All FHIR elements must have a @value or children ii-24-332-1: If not null then source value from (9000010.11-.01 > 9999999.14-.01)
patient	SΣ	1..1	Reference(Patient)	Who was immunized ele-1: All FHIR elements must have a @value or children
encounter	S	0..1	Reference(Encounter: Outpatient)	Encounter immunization was part of ele-1: All FHIR elements must have a @value or children
Slices for occurrence[x]	SΣ	1..1		Vaccine administration date Slice: Unordered, Open by type:$this ele-1: All FHIR elements must have a @value or children
occurrenceDateTime			dateTime
occurrence[x]:occurrenceDateTime	SΣ	0..1	dateTime	Vaccine administration date ele-1: All FHIR elements must have a @value or children
recorded	S	0..1	dateTime	When the immunization was first captured in the subject's record ele-1: All FHIR elements must have a @value or children
primarySource	SΣ	1..1	boolean	Indicates context the data was recorded in ele-1: All FHIR elements must have a @value or children
location	S	0..1	Reference(Location)	Where immunization occurred ele-1: All FHIR elements must have a @value or children
manufacturer	S	0..1	Reference(Organization)	Vaccine manufacturer ele-1: All FHIR elements must have a @value or children
lotNumber	S	0..1	string	Vaccine lot number ele-1: All FHIR elements must have a @value or children
doseQuantity	S	0..1	SimpleQuantity	Amount of vaccine administered ele-1: All FHIR elements must have a @value or children
value	SΣ	0..1	decimal	Numerical value (with implicit precision) ele-1: All FHIR elements must have a @value or children
unit	SΣ	0..1	string	Unit representation ele-1: All FHIR elements must have a @value or children
code	SΣ	0..1	code	Coded form of the unit ele-1: All FHIR elements must have a @value or children
performer	Σ	0..*	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
function	SΣ	0..1	CodeableConcept	What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event. ele-1: All FHIR elements must have a @value or children 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	SΣ	1..1	Reference(Practitioner)	Individual or organization who was performing ele-1: All FHIR elements must have a @value or children
note	Σ	0..*	Annotation	Additional immunization notes ele-1: All FHIR elements must have a @value or children
text	SΣ	1..1	markdown	The annotation - text content (as markdown) ele-1: All FHIR elements must have a @value or children
isSubpotent	?!Σ	0..1	boolean	Dose potency ele-1: All FHIR elements must have a @value or children
reaction		0..*	BackboneElement	Details of a reaction that follows immunization ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
detail	S	0..1	Reference(Immunization Observation)	Additional information on reaction ele-1: All FHIR elements must have a @value or children
protocolApplied		0..*	BackboneElement	Protocol followed by the provider ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for doseNumber[x]		1..1		Dose number within series Slice: Unordered, Open by type:$this ele-1: All FHIR elements must have a @value or children
doseNumberPositiveInt			positiveInt
doseNumberString			string
doseNumber[x]:doseNumberString	S	0..1	string	Dose number within series ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Immunization.status	required	ImmunizationStatusCodes http://hl7.org/fhir/ValueSet/immunization-status from the FHIR Standard
Immunization.statusReason	required	ImmunizationStatusReason http://va.gov/fhir/ValueSet/immunizationStatusReason from this IG
Immunization.vaccineCode	required	InferredCVX http://va.gov/fhir/ValueSet/inferredCVX from this IG
Immunization.performer.function	extensible	Pattern: AP http://hl7.org/fhir/ValueSet/immunization-function from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
ii-24-297	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed : true
ii-24-298	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record : true
ii-24-299	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done : true
ii-24-332	warning	Immunization.vaccineCode.coding:va-cvx.code	If not null then source value from (9000010.11-.01 > 9999999.14-.03) : true
ii-24-527	warning	Immunization.statusReason	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason : true
ii-24-528	warning	Immunization.vaccineCode	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX : true
ii-24-332-1	warning	Immunization.vaccineCode.text	If not null then source value from (9000010.11-.01 > 9999999.14-.01) : true
ii-24-332-2	warning	Immunization.vaccineCode.coding:va-cvx.system	If not null then fixed value http://hl7.org/fhir/sid/cvx : true
us-core-5	best practice	Immunization	SHOULD have a translation to the NDC value set : vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').empty()

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	USCoreImmunizationProfile(5.0.1)	Immunization event information This profile also complies with the profiles US Core Immunization Profile (6.1.0) and US Core Immunization Profile (7.0.0)
status	C	1..1	code	completed | entered-in-error | not-done ii-24-297: If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed ii-24-298: If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record ii-24-299: If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done
statusReason	C	0..1	CodeableConcept	Reason not done Binding: immunizationStatusReason FHIR (required): see mapping VF_immunizationStatusReason ii-24-527: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason
vaccineCode	C	1..1	CodeableConcept	Vaccine Product Type (bind to CVX) Binding: inferredCVX FHIR (required): see mapping VF_inferredCVX ii-24-528: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:va-cvx		0..1	Coding	Code defined by a terminology system
system	SC	0..1	uri	Identity of the terminology system ii-24-332-2: If not null then fixed value http://hl7.org/fhir/sid/cvx
code	SC	0..1	code	Symbol in syntax defined by the system ii-24-332: If not null then source value from (9000010.11-.01 > 9999999.14-.03)
coding:va-ndc		0..1	Coding	Code defined by a terminology system
system	S	0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/ndc
code	S	0..1	code	Symbol in syntax defined by the system
text	SC	0..1	string	Plain text representation of the concept ii-24-332-1: If not null then source value from (9000010.11-.01 > 9999999.14-.01)
patient		1..1	Reference(Patient)	Who was immunized
encounter	S	0..1	Reference(Encounter: Outpatient)	Encounter immunization was part of
Slices for occurrence[x]		1..1	dateTime, string	Vaccine administration date Slice: Unordered, Open by type:$this
occurrence[x]:occurrenceDateTime	S	0..1	dateTime S	Vaccine administration date
recorded	S	0..1	dateTime	When the immunization was first captured in the subject's record
primarySource		1..1	boolean	Indicates context the data was recorded in
location	S	0..1	Reference(Location)	Where immunization occurred
manufacturer	S	0..1	Reference(Organization)	Vaccine manufacturer
lotNumber	S	0..1	string	Vaccine lot number
doseQuantity	S	0..1	SimpleQuantity	Amount of vaccine administered
value	S	0..1	decimal	Numerical value (with implicit precision)
unit	S	0..1	string	Unit representation
code	S	0..1	code	Coded form of the unit
performer
function	S	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	S	1..1	Reference(Practitioner)	Individual or organization who was performing
note
text	S	1..1	markdown	The annotation - text content (as markdown)
reaction
detail	S	0..1	Reference(Immunization Observation)	Additional information on reaction
protocolApplied
Slices for doseNumber[x]		1..1	positiveInt, string	Dose number within series Slice: Unordered, Open by type:$this
doseNumber[x]:doseNumberString	S	0..1	string	Dose number within series
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Immunization.statusReason	required	ImmunizationStatusReason http://va.gov/fhir/ValueSet/immunizationStatusReason from this IG
Immunization.vaccineCode	required	InferredCVX http://va.gov/fhir/ValueSet/inferredCVX from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
ii-24-297	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed : true
ii-24-298	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record : true
ii-24-299	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done : true
ii-24-332	warning	Immunization.vaccineCode.coding:va-cvx.code	If not null then source value from (9000010.11-.01 > 9999999.14-.03) : true
ii-24-527	warning	Immunization.statusReason	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason : true
ii-24-528	warning	Immunization.vaccineCode	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX : true
ii-24-332-1	warning	Immunization.vaccineCode.text	If not null then source value from (9000010.11-.01 > 9999999.14-.01) : true
ii-24-332-2	warning	Immunization.vaccineCode.coding:va-cvx.system	If not null then fixed value http://hl7.org/fhir/sid/cvx : true

Name	Flags	Card.	Type	Description & Constraints
Immunization	C	0..*	USCoreImmunizationProfile(5.0.1)	Immunization event information This profile also complies with the profiles US Core Immunization Profile (6.1.0) and US Core Immunization Profile (7.0.0) us-core-5: SHOULD have a translation to the NDC value set
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Business identifier
status	?!SΣC	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required) ii-24-297: If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed ii-24-298: If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record ii-24-299: If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done
statusReason	SC	0..1	CodeableConcept	Reason not done Binding: immunizationStatusReason FHIR (required): see mapping VF_immunizationStatusReason ii-24-527: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason
vaccineCode	SΣC	1..1	CodeableConcept	Vaccine Product Type (bind to CVX) Binding: inferredCVX FHIR (required): see mapping VF_inferredCVX ii-24-528: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:va-cvx	Σ	0..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	0..1	uri	Identity of the terminology system ii-24-332-2: If not null then fixed value http://hl7.org/fhir/sid/cvx
version	Σ	0..1	string	Version of the system - if relevant
code	SΣC	0..1	code	Symbol in syntax defined by the system ii-24-332: If not null then source value from (9000010.11-.01 > 9999999.14-.03)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:va-ndc	Σ	0..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/ndc
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	SΣC	0..1	string	Plain text representation of the concept ii-24-332-1: If not null then source value from (9000010.11-.01 > 9999999.14-.01)
patient	SΣ	1..1	Reference(Patient)	Who was immunized
encounter	S	0..1	Reference(Encounter: Outpatient)	Encounter immunization was part of
Slices for occurrence[x]	SΣ	1..1		Vaccine administration date Slice: Unordered, Open by type:$this
occurrenceDateTime			dateTime S
occurrenceString			string
occurrence[x]:occurrenceDateTime	SΣ	0..1	dateTime S	Vaccine administration date
recorded	S	0..1	dateTime	When the immunization was first captured in the subject's record
primarySource	SΣ	1..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	S	0..1	Reference(Location)	Where immunization occurred
manufacturer	S	0..1	Reference(Organization)	Vaccine manufacturer
lotNumber	S	0..1	string	Vaccine 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	S	0..1	SimpleQuantity	Amount of vaccine administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	0..1	decimal	Numerical value (with implicit precision)
unit	SΣ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	SΣ	0..1	code	Coded form of the unit
performer	Σ	0..*	BackboneElement	Who performed event
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	SΣ	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	SΣ	1..1	Reference(Practitioner)	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	SΣ	1..1	markdown	The annotation - text content (as markdown)
reasonCode		0..*	CodeableConcept	Why immunization occurred 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 imm-1: One of documentType or reference SHALL be present
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	S	0..1	Reference(Immunization 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: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.
Slices for doseNumber[x]		1..1		Dose number within series Slice: Unordered, Open by type:$this
doseNumberPositiveInt			positiveInt
doseNumberString			string
doseNumber[x]:doseNumberString	S	0..1	string	Dose number within series
seriesDoses[x]		0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Immunization.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Immunization.status	required	ImmunizationStatusCodes http://hl7.org/fhir/ValueSet/immunization-status from the FHIR Standard
Immunization.statusReason	required	ImmunizationStatusReason http://va.gov/fhir/ValueSet/immunizationStatusReason from this IG
Immunization.vaccineCode	required	InferredCVX http://va.gov/fhir/ValueSet/inferredCVX from this IG
Immunization.reportOrigin	example	ImmunizationOriginCodes http://hl7.org/fhir/ValueSet/immunization-origin from the FHIR Standard
Immunization.site	example	CodesForImmunizationSiteOfAdministration http://hl7.org/fhir/ValueSet/immunization-site from the FHIR Standard
Immunization.route	example	ImmunizationRouteCodes http://hl7.org/fhir/ValueSet/immunization-route from the FHIR Standard
Immunization.performer.function	extensible	Pattern: AP http://hl7.org/fhir/ValueSet/immunization-function from the FHIR Standard
Immunization.reasonCode	example	ImmunizationReasonCodes http://hl7.org/fhir/ValueSet/immunization-reason from the FHIR Standard
Immunization.subpotentReason	example	ImmunizationSubpotentReason http://hl7.org/fhir/ValueSet/immunization-subpotent-reason from the FHIR Standard
Immunization.programEligibility	example	ImmunizationProgramEligibility http://hl7.org/fhir/ValueSet/immunization-program-eligibility from the FHIR Standard
Immunization.fundingSource	example	ImmunizationFundingSource http://hl7.org/fhir/ValueSet/immunization-funding-source from the FHIR Standard
Immunization.protocolApplied.targetDisease	example	ImmunizationTargetDiseaseCodes http://hl7.org/fhir/ValueSet/immunization-target-disease from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
ii-24-297	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed : true
ii-24-298	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record : true
ii-24-299	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done : true
ii-24-332	warning	Immunization.vaccineCode.coding:va-cvx.code	If not null then source value from (9000010.11-.01 > 9999999.14-.03) : true
ii-24-527	warning	Immunization.statusReason	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason : true
ii-24-528	warning	Immunization.vaccineCode	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX : true
ii-24-332-1	warning	Immunization.vaccineCode.text	If not null then source value from (9000010.11-.01 > 9999999.14-.01) : true
ii-24-332-2	warning	Immunization.vaccineCode.coding:va-cvx.system	If not null then fixed value http://hl7.org/fhir/sid/cvx : true
imm-1	error	Immunization.education	One of documentType or reference SHALL be present : documentType.exists() or reference.exists()
us-core-5	best practice	Immunization	SHOULD have a translation to the NDC value set : vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').empty()

Summary

Must-Support: 20 elements

Structures

This structure refers to these other structures:

• Patient (http://va.gov/fhir/StructureDefinition/Patient)
• Encounter: Outpatient (http://va.gov/fhir/StructureDefinition/EncounterOutpatient)
• Location (http://va.gov/fhir/StructureDefinition/Location)
• Practitioner (http://va.gov/fhir/StructureDefinition/Practitioner)
• Immunization Observation (http://va.gov/fhir/StructureDefinition/ImmunizationObservation)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Immunization.vaccineCode.coding
• The element 1 is sliced based on the value of Immunization.occurrence[x]
• The element 1 is sliced based on the value of Immunization.protocolApplied.doseNumber[x]

Name	Flags	Card.	Type	Description & Constraints
Immunization	C	0..*	USCoreImmunizationProfile(5.0.1)	Immunization event information This profile also complies with the profiles US Core Immunization Profile (6.1.0) and US Core Immunization Profile (7.0.0) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management us-core-5: SHOULD have a translation to the NDC value set
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣC	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required) ele-1: All FHIR elements must have a @value or children ii-24-297: If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed ii-24-298: If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record ii-24-299: If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done
statusReason	SC	0..1	CodeableConcept	Reason not done Binding: immunizationStatusReason FHIR (required): see mapping VF_immunizationStatusReason ele-1: All FHIR elements must have a @value or children ii-24-527: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason
vaccineCode	SΣC	1..1	CodeableConcept	Vaccine Product Type (bind to CVX) Binding: inferredCVX FHIR (required): see mapping VF_inferredCVX ele-1: All FHIR elements must have a @value or children ii-24-528: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this ele-1: All FHIR elements must have a @value or children
coding:va-cvx	Σ	0..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	SΣC	0..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children ii-24-332-2: If not null then fixed value http://hl7.org/fhir/sid/cvx
code	SΣC	0..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children ii-24-332: If not null then source value from (9000010.11-.01 > 9999999.14-.03)
coding:va-ndc	Σ	0..1	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	SΣ	0..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Required Pattern: http://hl7.org/fhir/sid/ndc
code	SΣ	0..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children
text	SΣC	0..1	string	Plain text representation of the concept ele-1: All FHIR elements must have a @value or children ii-24-332-1: If not null then source value from (9000010.11-.01 > 9999999.14-.01)
patient	SΣ	1..1	Reference(Patient)	Who was immunized ele-1: All FHIR elements must have a @value or children
encounter	S	0..1	Reference(Encounter: Outpatient)	Encounter immunization was part of ele-1: All FHIR elements must have a @value or children
Slices for occurrence[x]	SΣ	1..1		Vaccine administration date Slice: Unordered, Open by type:$this ele-1: All FHIR elements must have a @value or children
occurrenceDateTime			dateTime
occurrence[x]:occurrenceDateTime	SΣ	0..1	dateTime	Vaccine administration date ele-1: All FHIR elements must have a @value or children
recorded	S	0..1	dateTime	When the immunization was first captured in the subject's record ele-1: All FHIR elements must have a @value or children
primarySource	SΣ	1..1	boolean	Indicates context the data was recorded in ele-1: All FHIR elements must have a @value or children
location	S	0..1	Reference(Location)	Where immunization occurred ele-1: All FHIR elements must have a @value or children
manufacturer	S	0..1	Reference(Organization)	Vaccine manufacturer ele-1: All FHIR elements must have a @value or children
lotNumber	S	0..1	string	Vaccine lot number ele-1: All FHIR elements must have a @value or children
doseQuantity	S	0..1	SimpleQuantity	Amount of vaccine administered ele-1: All FHIR elements must have a @value or children
value	SΣ	0..1	decimal	Numerical value (with implicit precision) ele-1: All FHIR elements must have a @value or children
unit	SΣ	0..1	string	Unit representation ele-1: All FHIR elements must have a @value or children
code	SΣ	0..1	code	Coded form of the unit ele-1: All FHIR elements must have a @value or children
performer	Σ	0..*	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
function	SΣ	0..1	CodeableConcept	What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event. ele-1: All FHIR elements must have a @value or children 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	SΣ	1..1	Reference(Practitioner)	Individual or organization who was performing ele-1: All FHIR elements must have a @value or children
note	Σ	0..*	Annotation	Additional immunization notes ele-1: All FHIR elements must have a @value or children
text	SΣ	1..1	markdown	The annotation - text content (as markdown) ele-1: All FHIR elements must have a @value or children
isSubpotent	?!Σ	0..1	boolean	Dose potency ele-1: All FHIR elements must have a @value or children
reaction		0..*	BackboneElement	Details of a reaction that follows immunization ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
detail	S	0..1	Reference(Immunization Observation)	Additional information on reaction ele-1: All FHIR elements must have a @value or children
protocolApplied		0..*	BackboneElement	Protocol followed by the provider ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for doseNumber[x]		1..1		Dose number within series Slice: Unordered, Open by type:$this ele-1: All FHIR elements must have a @value or children
doseNumberPositiveInt			positiveInt
doseNumberString			string
doseNumber[x]:doseNumberString	S	0..1	string	Dose number within series ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Immunization.status	required	ImmunizationStatusCodes http://hl7.org/fhir/ValueSet/immunization-status from the FHIR Standard
Immunization.statusReason	required	ImmunizationStatusReason http://va.gov/fhir/ValueSet/immunizationStatusReason from this IG
Immunization.vaccineCode	required	InferredCVX http://va.gov/fhir/ValueSet/inferredCVX from this IG
Immunization.performer.function	extensible	Pattern: AP http://hl7.org/fhir/ValueSet/immunization-function from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
ii-24-297	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed : true
ii-24-298	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record : true
ii-24-299	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done : true
ii-24-332	warning	Immunization.vaccineCode.coding:va-cvx.code	If not null then source value from (9000010.11-.01 > 9999999.14-.03) : true
ii-24-527	warning	Immunization.statusReason	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason : true
ii-24-528	warning	Immunization.vaccineCode	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX : true
ii-24-332-1	warning	Immunization.vaccineCode.text	If not null then source value from (9000010.11-.01 > 9999999.14-.01) : true
ii-24-332-2	warning	Immunization.vaccineCode.coding:va-cvx.system	If not null then fixed value http://hl7.org/fhir/sid/cvx : true
us-core-5	best practice	Immunization	SHOULD have a translation to the NDC value set : vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').empty()

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	USCoreImmunizationProfile(5.0.1)	Immunization event information This profile also complies with the profiles US Core Immunization Profile (6.1.0) and US Core Immunization Profile (7.0.0)
status	C	1..1	code	completed | entered-in-error | not-done ii-24-297: If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed ii-24-298: If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record ii-24-299: If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done
statusReason	C	0..1	CodeableConcept	Reason not done Binding: immunizationStatusReason FHIR (required): see mapping VF_immunizationStatusReason ii-24-527: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason
vaccineCode	C	1..1	CodeableConcept	Vaccine Product Type (bind to CVX) Binding: inferredCVX FHIR (required): see mapping VF_inferredCVX ii-24-528: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:va-cvx		0..1	Coding	Code defined by a terminology system
system	SC	0..1	uri	Identity of the terminology system ii-24-332-2: If not null then fixed value http://hl7.org/fhir/sid/cvx
code	SC	0..1	code	Symbol in syntax defined by the system ii-24-332: If not null then source value from (9000010.11-.01 > 9999999.14-.03)
coding:va-ndc		0..1	Coding	Code defined by a terminology system
system	S	0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/ndc
code	S	0..1	code	Symbol in syntax defined by the system
text	SC	0..1	string	Plain text representation of the concept ii-24-332-1: If not null then source value from (9000010.11-.01 > 9999999.14-.01)
patient		1..1	Reference(Patient)	Who was immunized
encounter	S	0..1	Reference(Encounter: Outpatient)	Encounter immunization was part of
Slices for occurrence[x]		1..1	dateTime, string	Vaccine administration date Slice: Unordered, Open by type:$this
occurrence[x]:occurrenceDateTime	S	0..1	dateTime S	Vaccine administration date
recorded	S	0..1	dateTime	When the immunization was first captured in the subject's record
primarySource		1..1	boolean	Indicates context the data was recorded in
location	S	0..1	Reference(Location)	Where immunization occurred
manufacturer	S	0..1	Reference(Organization)	Vaccine manufacturer
lotNumber	S	0..1	string	Vaccine lot number
doseQuantity	S	0..1	SimpleQuantity	Amount of vaccine administered
value	S	0..1	decimal	Numerical value (with implicit precision)
unit	S	0..1	string	Unit representation
code	S	0..1	code	Coded form of the unit
performer
function	S	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	S	1..1	Reference(Practitioner)	Individual or organization who was performing
note
text	S	1..1	markdown	The annotation - text content (as markdown)
reaction
detail	S	0..1	Reference(Immunization Observation)	Additional information on reaction
protocolApplied
Slices for doseNumber[x]		1..1	positiveInt, string	Dose number within series Slice: Unordered, Open by type:$this
doseNumber[x]:doseNumberString	S	0..1	string	Dose number within series
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Immunization.statusReason	required	ImmunizationStatusReason http://va.gov/fhir/ValueSet/immunizationStatusReason from this IG
Immunization.vaccineCode	required	InferredCVX http://va.gov/fhir/ValueSet/inferredCVX from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
ii-24-297	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed : true
ii-24-298	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record : true
ii-24-299	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done : true
ii-24-332	warning	Immunization.vaccineCode.coding:va-cvx.code	If not null then source value from (9000010.11-.01 > 9999999.14-.03) : true
ii-24-527	warning	Immunization.statusReason	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason : true
ii-24-528	warning	Immunization.vaccineCode	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX : true
ii-24-332-1	warning	Immunization.vaccineCode.text	If not null then source value from (9000010.11-.01 > 9999999.14-.01) : true
ii-24-332-2	warning	Immunization.vaccineCode.coding:va-cvx.system	If not null then fixed value http://hl7.org/fhir/sid/cvx : true

Name	Flags	Card.	Type	Description & Constraints
Immunization	C	0..*	USCoreImmunizationProfile(5.0.1)	Immunization event information This profile also complies with the profiles US Core Immunization Profile (6.1.0) and US Core Immunization Profile (7.0.0) us-core-5: SHOULD have a translation to the NDC value set
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Business identifier
status	?!SΣC	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required) ii-24-297: If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed ii-24-298: If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record ii-24-299: If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done
statusReason	SC	0..1	CodeableConcept	Reason not done Binding: immunizationStatusReason FHIR (required): see mapping VF_immunizationStatusReason ii-24-527: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason
vaccineCode	SΣC	1..1	CodeableConcept	Vaccine Product Type (bind to CVX) Binding: inferredCVX FHIR (required): see mapping VF_inferredCVX ii-24-528: If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:va-cvx	Σ	0..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	0..1	uri	Identity of the terminology system ii-24-332-2: If not null then fixed value http://hl7.org/fhir/sid/cvx
version	Σ	0..1	string	Version of the system - if relevant
code	SΣC	0..1	code	Symbol in syntax defined by the system ii-24-332: If not null then source value from (9000010.11-.01 > 9999999.14-.03)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:va-ndc	Σ	0..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/ndc
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	SΣC	0..1	string	Plain text representation of the concept ii-24-332-1: If not null then source value from (9000010.11-.01 > 9999999.14-.01)
patient	SΣ	1..1	Reference(Patient)	Who was immunized
encounter	S	0..1	Reference(Encounter: Outpatient)	Encounter immunization was part of
Slices for occurrence[x]	SΣ	1..1		Vaccine administration date Slice: Unordered, Open by type:$this
occurrenceDateTime			dateTime S
occurrenceString			string
occurrence[x]:occurrenceDateTime	SΣ	0..1	dateTime S	Vaccine administration date
recorded	S	0..1	dateTime	When the immunization was first captured in the subject's record
primarySource	SΣ	1..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	S	0..1	Reference(Location)	Where immunization occurred
manufacturer	S	0..1	Reference(Organization)	Vaccine manufacturer
lotNumber	S	0..1	string	Vaccine 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	S	0..1	SimpleQuantity	Amount of vaccine administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	0..1	decimal	Numerical value (with implicit precision)
unit	SΣ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	SΣ	0..1	code	Coded form of the unit
performer	Σ	0..*	BackboneElement	Who performed event
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	SΣ	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	SΣ	1..1	Reference(Practitioner)	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	SΣ	1..1	markdown	The annotation - text content (as markdown)
reasonCode		0..*	CodeableConcept	Why immunization occurred 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 imm-1: One of documentType or reference SHALL be present
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	S	0..1	Reference(Immunization 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: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.
Slices for doseNumber[x]		1..1		Dose number within series Slice: Unordered, Open by type:$this
doseNumberPositiveInt			positiveInt
doseNumberString			string
doseNumber[x]:doseNumberString	S	0..1	string	Dose number within series
seriesDoses[x]		0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Immunization.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Immunization.status	required	ImmunizationStatusCodes http://hl7.org/fhir/ValueSet/immunization-status from the FHIR Standard
Immunization.statusReason	required	ImmunizationStatusReason http://va.gov/fhir/ValueSet/immunizationStatusReason from this IG
Immunization.vaccineCode	required	InferredCVX http://va.gov/fhir/ValueSet/inferredCVX from this IG
Immunization.reportOrigin	example	ImmunizationOriginCodes http://hl7.org/fhir/ValueSet/immunization-origin from the FHIR Standard
Immunization.site	example	CodesForImmunizationSiteOfAdministration http://hl7.org/fhir/ValueSet/immunization-site from the FHIR Standard
Immunization.route	example	ImmunizationRouteCodes http://hl7.org/fhir/ValueSet/immunization-route from the FHIR Standard
Immunization.performer.function	extensible	Pattern: AP http://hl7.org/fhir/ValueSet/immunization-function from the FHIR Standard
Immunization.reasonCode	example	ImmunizationReasonCodes http://hl7.org/fhir/ValueSet/immunization-reason from the FHIR Standard
Immunization.subpotentReason	example	ImmunizationSubpotentReason http://hl7.org/fhir/ValueSet/immunization-subpotent-reason from the FHIR Standard
Immunization.programEligibility	example	ImmunizationProgramEligibility http://hl7.org/fhir/ValueSet/immunization-program-eligibility from the FHIR Standard
Immunization.fundingSource	example	ImmunizationFundingSource http://hl7.org/fhir/ValueSet/immunization-funding-source from the FHIR Standard
Immunization.protocolApplied.targetDisease	example	ImmunizationTargetDiseaseCodes http://hl7.org/fhir/ValueSet/immunization-target-disease from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
ii-24-297	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.03) is CVX populated then fixed value #completed : true
ii-24-298	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is missing or unknown then exclude record : true
ii-24-299	warning	Immunization.status	If (9000010.11-.01 > 9999999.14-.01) is text like 'contraindicated', 'refused', 'decline', 'not avail' then fixed value #not-done : true
ii-24-332	warning	Immunization.vaccineCode.coding:va-cvx.code	If not null then source value from (9000010.11-.01 > 9999999.14-.03) : true
ii-24-527	warning	Immunization.statusReason	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_immunizationStatusReason : true
ii-24-528	warning	Immunization.vaccineCode	If V IMMUNIZATION - IMMUNIZATION null then terminologyMaps (9000010.11-.01 > 9999999.14-.01) using VF_inferredCVX : true
ii-24-332-1	warning	Immunization.vaccineCode.text	If not null then source value from (9000010.11-.01 > 9999999.14-.01) : true
ii-24-332-2	warning	Immunization.vaccineCode.coding:va-cvx.system	If not null then fixed value http://hl7.org/fhir/sid/cvx : true
imm-1	error	Immunization.education	One of documentType or reference SHALL be present : documentType.exists() or reference.exists()
us-core-5	best practice	Immunization	SHOULD have a translation to the NDC value set : vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').empty()