{"abstract":false,"baseDefinition":"http://hl7.org/fhir/StructureDefinition/DomainResource","contact":[{"telecom":[{"system":"url","value":"http://hl7.org/fhir"}]},{"telecom":[{"system":"url","value":"http://www.hl7.org/Special/committees/pher/index.cfm"}]}],"date":"2023-03-26T15:21:02+11:00","derivation":"specialization","description":"A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.","differential":{"element":[{"definition":"A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting 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recommendation.","id":"ImmunizationRecommendation.recommendation.targetDisease","isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"},{"identity":"rim","map":".partipication[typeCode=CSM].role[classCode=ADMM].code"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.targetDisease","short":"Disease to be immunized against","type":[{"code":"CodeableConcept"}]},{"binding":{"description":"The type of vaccine administered.","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"VaccineCode"}],"strength":"example","valueSet":"http://hl7.org/fhir/ValueSet/vaccine-code"},"definition":"Vaccine(s) which should not be used to fulfill the recommendation.","id":"ImmunizationRecommendation.recommendation.contraindicatedVaccineCode","isModifier":false,"isSummary":true,"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.contraindicatedVaccineCode","short":"Vaccine which is contraindicated to fulfill the recommendation","type":[{"code":"CodeableConcept"}]},{"binding":{"description":"The patient's status with respect to a vaccination protocol.","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ImmunizationRecommendationStatus"}],"strength":"example","valueSet":"http://hl7.org/fhir/ValueSet/immunization-recommendation-status"},"definition":"Indicates the patient status with respect to the path to immunity for the target disease.","id":"ImmunizationRecommendation.recommendation.forecastStatus","isModifier":true,"isModifierReason":"This element is labeled as a modifier because the forecastStatus indicates whether a patient needs 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A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).","definition":"Nominal position of the recommended dose in a series as determined by the evaluation and forecasting process (e.g. dose 2 is the next recommended dose).","id":"ImmunizationRecommendation.recommendation.doseNumber","isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"OBX-5 : OBX-3 = 30973-2"},{"identity":"rim","map":".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber"}],"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.doseNumber","short":"Recommended dose number within series","type":[{"code":"string"}]},{"comment":"The use of an integer is preferred if known.","definition":"The recommended number of doses to achieve immunity as determined by the evaluation and forecasting process.","id":"ImmunizationRecommendation.recommendation.seriesDoses","isModifier":false,"isSummary":false,"mapping":[{"identity":"v2","map":"OBX-5 : OBX-3 = 59782-3"},{"identity":"rim","map":".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber"}],"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.seriesDoses","short":"Recommended number of doses for immunity","type":[{"code":"string"}]},{"definition":"Immunization event history and/or evaluation that supports the status and recommendation.","id":"ImmunizationRecommendation.recommendation.supportingImmunization","isModifier":false,"isSummary":false,"mapping":[{"identity":"v2","map":"? No clear way to associate in HL7 V2 or IG"},{"identity":"rim","map":".outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code=\"immunization\"]"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.supportingImmunization","short":"Past immunizations supporting recommendation","type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Immunization","http://hl7.org/fhir/StructureDefinition/ImmunizationEvaluation"]}]},{"definition":"Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information.","id":"ImmunizationRecommendation.recommendation.supportingPatientInformation","isModifier":false,"isSummary":false,"mapping":[{"identity":"workflow","map":"Request.supportingInfo"},{"identity":"v2","map":"OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine administered^CVX'), could contain the reason the vaccine was not administered"},{"identity":"rim","map":".outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.supportingPatientInformation","short":"Patient observations supporting recommendation","type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Resource"]}]}]},"experimental":false,"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-category","valueString":"Clinical.Medications"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status","valueCode":"trial-use"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm","valueInteger":1},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category","valueCode":"patient"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-wg","valueCode":"pher"}],"fhirVersion":"5.0.0","id":"ImmunizationRecommendation","jurisdiction":[{"coding":[{"code":"001","display":"World","system":"http://unstats.un.org/unsd/methods/m49/m49.htm"}]}],"kind":"resource","mapping":[{"identity":"workflow","name":"Workflow Pattern","uri":"http://hl7.org/fhir/workflow"},{"identity":"w5","name":"FiveWs Pattern Mapping","uri":"http://hl7.org/fhir/fivews"},{"identity":"v2","name":"HL7 V2 Mapping","uri":"http://hl7.org/v2"},{"identity":"rim","name":"RIM Mapping","uri":"http://hl7.org/v3"}],"meta":{"lastUpdated":"2023-03-26T15:21:02.749+11:00"},"name":"ImmunizationRecommendation","publisher":"Health Level Seven International (Public Health and Emergency Response)","resourceType":"StructureDefinition","snapshot":{"element":[{"base":{"max":"*","min":0,"path":"ImmunizationRecommendation"},"constraint":[{"expression":"contained.contained.empty()","human":"If the resource is contained in another resource, it SHALL NOT contain nested Resources","key":"dom-2","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"expression":"contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()","human":"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","key":"dom-3","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"expression":"contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()","human":"If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated","key":"dom-4","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"expression":"contained.meta.security.empty()","human":"If a resource is contained in another resource, it SHALL NOT have a security label","key":"dom-5","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"expression":"text.`div`.exists()","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice","valueBoolean":true},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation","valueMarkdown":"When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."}],"human":"A resource should have narrative for robust management","key":"dom-6","severity":"warning","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"}],"definition":"A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.","id":"ImmunizationRecommendation","isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"Entity, Role, or Act,SubstanceAdministration[moodCode=RMD]"},{"identity":"workflow","map":"Request"},{"identity":"w5","map":"clinical.medication"},{"identity":"v2","map":"VXU_V04"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation","short":"Guidance or advice relating to an immunization"},{"base":{"max":"1","min":0,"path":"Resource.id"},"comment":"Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.","definition":"The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.","id":"ImmunizationRecommendation.id","isModifier":false,"isSummary":true,"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.id","short":"Logical id of this artifact","type":[{"code":"http://hl7.org/fhirpath/System.String","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"id"}]}]},{"base":{"max":"1","min":0,"path":"Resource.meta"},"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.","id":"ImmunizationRecommendation.meta","isModifier":false,"isSummary":true,"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.meta","short":"Metadata about the resource","type":[{"code":"Meta"}]},{"base":{"max":"1","min":0,"path":"Resource.implicitRules"},"comment":"Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.","constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.","id":"ImmunizationRecommendation.implicitRules","isModifier":true,"isModifierReason":"This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation","isSummary":true,"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.implicitRules","short":"A set of rules under which this content was created","type":[{"code":"uri"}]},{"base":{"max":"1","min":0,"path":"Resource.language"},"binding":{"additional":[{"purpose":"starter","valueSet":"http://hl7.org/fhir/ValueSet/languages"}],"description":"IETF language tag for a human language","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Language"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"required","valueSet":"http://hl7.org/fhir/ValueSet/all-languages|5.0.0"},"comment":"Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).","constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"The base language in which the resource is written.","id":"ImmunizationRecommendation.language","isModifier":false,"isSummary":false,"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.language","short":"Language of the resource content","type":[{"code":"code"}]},{"alias":["narrative","html","xhtml","display"],"base":{"max":"1","min":0,"path":"DomainResource.text"},"comment":"Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.","condition":["dom-6"],"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.","id":"ImmunizationRecommendation.text","isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"Act.text?"}],"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.text","short":"Text summary of the resource, for human interpretation","type":[{"code":"Narrative"}]},{"alias":["inline resources","anonymous resources","contained resources"],"base":{"max":"*","min":0,"path":"DomainResource.contained"},"comment":"This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.","condition":["dom-2","dom-4","dom-3","dom-5"],"definition":"These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.","id":"ImmunizationRecommendation.contained","isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"N/A"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.contained","short":"Contained, inline Resources","type":[{"code":"Resource"}]},{"alias":["extensions","user content"],"base":{"max":"*","min":0,"path":"DomainResource.extension"},"comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"expression":"extension.exists() != value.exists()","human":"Must have either extensions or value[x], not both","key":"ext-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"definition":"May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","id":"ImmunizationRecommendation.extension","isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"N/A"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.extension","short":"Additional content defined by implementations","type":[{"code":"Extension"}]},{"alias":["extensions","user content"],"base":{"max":"*","min":0,"path":"DomainResource.modifierExtension"},"comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"expression":"extension.exists() != value.exists()","human":"Must have either extensions or value[x], not both","key":"ext-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"definition":"May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","id":"ImmunizationRecommendation.modifierExtension","isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.modifierExtension","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).","short":"Extensions that cannot be ignored","type":[{"code":"Extension"}]},{"base":{"max":"*","min":0,"path":"ImmunizationRecommendation.identifier"},"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"A unique identifier assigned to this particular recommendation record.","id":"ImmunizationRecommendation.identifier","isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Request.identifier"},{"identity":"w5","map":"FiveWs.identifier"},{"identity":"rim","map":".id"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.identifier","short":"Business identifier","type":[{"code":"Identifier"}]},{"base":{"max":"1","min":1,"path":"ImmunizationRecommendation.patient"},"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"The patient the recommendation(s) are for.","id":"ImmunizationRecommendation.patient","isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Request.subject"},{"identity":"w5","map":"FiveWs.subject[x]"},{"identity":"v2","map":"PID-3"},{"identity":"rim","map":".partipication[typeCode=SUBJ].role"}],"max":"1","min":1,"mustSupport":false,"path":"ImmunizationRecommendation.patient","short":"Who this profile is for","type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Patient"]}]},{"base":{"max":"1","min":1,"path":"ImmunizationRecommendation.date"},"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"The date the immunization recommendation(s) were created.","id":"ImmunizationRecommendation.date","isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Request.authoredOn"},{"identity":"v2","map":"OBX-15"},{"identity":"rim","map":".partipication[typeCode=AUTH].time"}],"max":"1","min":1,"mustSupport":false,"path":"ImmunizationRecommendation.date","short":"Date recommendation(s) created","type":[{"code":"dateTime"}]},{"base":{"max":"1","min":0,"path":"ImmunizationRecommendation.authority"},"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"Indicates the authority who published the protocol (e.g. ACIP).","id":"ImmunizationRecommendation.authority","isModifier":false,"isSummary":false,"mapping":[{"identity":"v2","map":"OBX-5 : OBX-3 = 59779-9"},{"identity":"rim","map":".participation[typeCode=AUT]"}],"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.authority","short":"Who is responsible for protocol","type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Organization"]}]},{"base":{"max":"*","min":1,"path":"ImmunizationRecommendation.recommendation"},"comment":"A given instance of the .recommendation backbone element should correspond to a single recommended administration.","constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"expression":"vaccineCode.exists() or targetDisease.exists()","human":"One of vaccineCode or targetDisease SHALL be present","key":"imr-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"}],"definition":"Vaccine administration recommendations.","id":"ImmunizationRecommendation.recommendation","isModifier":false,"isSummary":true,"mapping":[{"identity":"rim","map":".outboundRelationship[typeCode='COMP'].target[classCode=SBADM, moodCode=RMD]"}],"max":"*","min":1,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation","short":"Vaccine administration recommendations","type":[{"code":"BackboneElement"}]},{"base":{"max":"1","min":0,"path":"Element.id"},"condition":["ele-1"],"definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","id":"ImmunizationRecommendation.recommendation.id","isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}],"max":"1","min":0,"path":"ImmunizationRecommendation.recommendation.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","type":[{"code":"http://hl7.org/fhirpath/System.String","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}]}]},{"alias":["extensions","user content"],"base":{"max":"*","min":0,"path":"Element.extension"},"comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"expression":"extension.exists() != value.exists()","human":"Must have either extensions or value[x], not both","key":"ext-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","id":"ImmunizationRecommendation.recommendation.extension","isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}],"max":"*","min":0,"path":"ImmunizationRecommendation.recommendation.extension","short":"Additional content defined by implementations","type":[{"code":"Extension"}]},{"alias":["extensions","user content","modifiers"],"base":{"max":"*","min":0,"path":"BackboneElement.modifierExtension"},"comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"expression":"extension.exists() != value.exists()","human":"Must have either extensions or value[x], not both","key":"ext-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","id":"ImmunizationRecommendation.recommendation.modifierExtension","isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}],"max":"*","min":0,"path":"ImmunizationRecommendation.recommendation.modifierExtension","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).","short":"Extensions that cannot be ignored even if unrecognized","type":[{"code":"Extension"}]},{"base":{"max":"*","min":0,"path":"ImmunizationRecommendation.recommendation.vaccineCode"},"binding":{"description":"The type of vaccine administered.","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"VaccineCode"}],"strength":"example","valueSet":"http://hl7.org/fhir/ValueSet/vaccine-code"},"condition":["imr-1"],"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"Vaccine(s) or vaccine group that pertain to the recommendation.","id":"ImmunizationRecommendation.recommendation.vaccineCode","isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Request.code"},{"identity":"v2","map":"OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"},{"identity":"rim","map":".partipication[typeCode=CSM].role[classCode=ADMM].code"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.vaccineCode","short":"Vaccine or vaccine group recommendation applies to","type":[{"code":"CodeableConcept"}]},{"base":{"max":"*","min":0,"path":"ImmunizationRecommendation.recommendation.targetDisease"},"binding":{"description":"The disease that the recommended vaccination targets.","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"TargetDisease"}],"strength":"example","valueSet":"http://hl7.org/fhir/ValueSet/immunization-target-disease"},"comment":"A given instance of the .recommendation backbone element should correspond to a single recommended administration but sometimes that administration (e.g. MMR) will encompass multiple diseases, thus the targetDisease element is allowed to repeat.","condition":["imr-1"],"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"The targeted disease for the recommendation.","id":"ImmunizationRecommendation.recommendation.targetDisease","isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"},{"identity":"rim","map":".partipication[typeCode=CSM].role[classCode=ADMM].code"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.targetDisease","short":"Disease to be immunized 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A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).","constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"Nominal position of the recommended dose in a series as determined by the evaluation and forecasting process (e.g. dose 2 is the next recommended dose).","id":"ImmunizationRecommendation.recommendation.doseNumber","isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"OBX-5 : OBX-3 = 30973-2"},{"identity":"rim","map":".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber"}],"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.doseNumber","short":"Recommended dose number within series","type":[{"code":"string"}]},{"base":{"max":"1","min":0,"path":"ImmunizationRecommendation.recommendation.seriesDoses"},"comment":"The use of an integer is preferred if known.","constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"The recommended number of doses to achieve immunity as determined by the evaluation and forecasting process.","id":"ImmunizationRecommendation.recommendation.seriesDoses","isModifier":false,"isSummary":false,"mapping":[{"identity":"v2","map":"OBX-5 : OBX-3 = 59782-3"},{"identity":"rim","map":".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber"}],"max":"1","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.seriesDoses","short":"Recommended number of doses for immunity","type":[{"code":"string"}]},{"base":{"max":"*","min":0,"path":"ImmunizationRecommendation.recommendation.supportingImmunization"},"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"Immunization event history and/or evaluation that supports the status and recommendation.","id":"ImmunizationRecommendation.recommendation.supportingImmunization","isModifier":false,"isSummary":false,"mapping":[{"identity":"v2","map":"? No clear way to associate in HL7 V2 or IG"},{"identity":"rim","map":".outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code=\"immunization\"]"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.supportingImmunization","short":"Past immunizations supporting recommendation","type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Immunization","http://hl7.org/fhir/StructureDefinition/ImmunizationEvaluation"]}]},{"base":{"max":"*","min":0,"path":"ImmunizationRecommendation.recommendation.supportingPatientInformation"},"constraint":[{"expression":"hasValue() or (children().count() > id.count())","human":"All FHIR elements must have a @value or children","key":"ele-1","severity":"error","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"definition":"Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information.","id":"ImmunizationRecommendation.recommendation.supportingPatientInformation","isModifier":false,"isSummary":false,"mapping":[{"identity":"workflow","map":"Request.supportingInfo"},{"identity":"v2","map":"OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine administered^CVX'), could contain the reason the vaccine was not administered"},{"identity":"rim","map":".outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]"}],"max":"*","min":0,"mustSupport":false,"path":"ImmunizationRecommendation.recommendation.supportingPatientInformation","short":"Patient observations supporting recommendation","type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Resource"]}]}]},"status":"draft","text":{"div":"
\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
NameFlagsCard.TypeDescription & Constraints\"doco\"
\".\"\".\" ImmunizationRecommendation TUDomainResourceGuidance or advice relating to an immunization

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
\".\"\".\"\".\" identifier Σ0..*IdentifierBusiness identifier

\".\"\".\"\".\" patient Σ1..1Reference(Patient)Who this profile is for
\".\"\".\"\".\" date Σ1..1dateTimeDate recommendation(s) created
\".\"\".\"\".\" authority 0..1Reference(Organization)Who is responsible for protocol
\".\"\".\"\".\" recommendation ΣC1..*BackboneElementVaccine administration recommendations
+ Rule: One of vaccineCode or targetDisease SHALL be present

\".\"\".\"\".\"\".\" vaccineCode ΣC0..*CodeableConceptVaccine or vaccine group recommendation applies to
Binding: Vaccine Administered Value Set (Example)

\".\"\".\"\".\"\".\" targetDisease ΣC0..*CodeableConceptDisease to be immunized against
Binding: Immunization Target Disease Codes (Example)

\".\"\".\"\".\"\".\" contraindicatedVaccineCode Σ0..*CodeableConceptVaccine which is contraindicated to fulfill the recommendation
Binding: Vaccine Administered Value Set (Example)

\".\"\".\"\".\"\".\" forecastStatus ?!Σ1..1CodeableConceptVaccine recommendation status
Binding: Immunization Recommendation Status Codes (Example)
\".\"\".\"\".\"\".\" forecastReason Σ0..*CodeableConceptVaccine administration status reason
Binding: Immunization Recommendation Reason Codes (Example)

\".\"\".\"\".\"\".\" dateCriterion 0..*BackboneElementDates governing proposed immunization

\".\"\".\"\".\"\".\"\".\" code 1..1CodeableConceptType of date
Binding: Immunization Recommendation Date Criterion Codes (Example)
\".\"\".\"\".\"\".\"\".\" value 1..1dateTimeRecommended date
\".\"\".\"\".\"\".\" description 0..1markdownProtocol details
\".\"\".\"\".\"\".\" series 0..1stringName of vaccination series
\".\"\".\"\".\"\".\" doseNumber Σ0..1stringRecommended dose number within series
\".\"\".\"\".\"\".\" seriesDoses 0..1stringRecommended number of doses for immunity
\".\"\".\"\".\"\".\" supportingImmunization 0..*Reference(Immunization | ImmunizationEvaluation)Past immunizations supporting recommendation

\".\"\".\"\".\"\".\" supportingPatientInformation 0..*Reference(Any)Patient observations supporting recommendation


\"doco\" Documentation for this format
","status":"generated"},"type":"ImmunizationRecommendation","url":"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation","version":"5.0.0"}