Name Flags Card. Type Description & Constraints Immunization 0..* Immunization Record of administered vaccine held in the AIR meta C 1..1 Meta Metadata about the resource inv-dh-imm-01: One profile shall be 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/immunization-air' profile 1..* uri Profiles this resource claims to conform to Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url serialNumber S 0..1 string Serial number URL: http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/vaccine-serial-number-1 identifier S 1..1 Identifier Business identifier status S 1..1 code completed | entered-in-error Fixed Value: completed notGiven S 1..1 boolean Flag for whether immunization was given Fixed Value: false vaccineCode S 1..1 CodeableConcept Brand name given Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-vaccine-1 (required) patient S 1..1 Reference(AU Base Patient) Who was immunized date S 1..1 dateTime Date given primarySource S 1..1 boolean Indicates context the data was recorded in Fixed Value: true lotNumber S 0..1 string Batch number vaccinationProtocol S 1..1 BackboneElement What protocol was followed doseSequence S 0..1 positiveInt Dose number within series targetDisease S 1..* CodeableConcept Antigen doseStatus 1..1 CodeableConcept Indicates if dose counts towards immunity 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://hl7.org/fhir/v3/NullFlavor code 1..1 code Symbol in syntax defined by the system Fixed Value: NAVU Documentation for this format
ADHA Australian Immunisation Register Immunization
The purpose of this profile is to define a representation of an administered vaccination, for an individual, held in the Australian Immunisation Register (AIR) for the electronic exchange of digital health information between Medicare repositories and the My Health Record system infrastructure in Australia.
Copyright © 2022 Australian Digital Health Agency - All rights reserved. This content is licensed under a Creative Commons Attribution 4.0 International License. See https://creativecommons.org/licenses/by/4.0/.
Record of administered vaccine held in the AIR
Describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL NOT contain any narrative
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty()
not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))
If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent.
(notGiven = true) or explanation.reasonNotGiven.empty()
not(f:notGiven/@value=false() and exists(f:explanation/f:reasonNotGiven))
If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present
(notGiven = true).not() or (reaction.empty() and explanation.reason.empty())
not(f:notGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason)))
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
One profile shall be 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/immunization-air'
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional Content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
When the resource last changed - e.g. when the version changed.
This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/STU3/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url]().
It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Security Labels applied to this resource
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Security Labels from the Healthcare Privacy and Security Classification System.
Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
Serial number for the vial of vaccine used in an administration.
All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
A unique identifier assigned to this immunization record.
Indicates the current status of the vaccination event.
Will generally be set to show that the immunization has been completed. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
A set of codes indicating the current status of an Immunization
Indicates if the vaccination was or was not given.
This element is labeled as a modifier because it indicates that an immunization didn't happen.
Vaccine that was administered or was to be administered.
The patient who either received or did not receive the immunization.
The visit or admission or other contact between patient and health care provider the immunization was performed as part of.
Date vaccine administered or was to be administered.
When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.
Indicates context the data was recorded in
An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.
Reflects the “reliability” of the content.
immunization.uncertaintycode (if primary source=false, uncertainty=U)
Indicates the source of a secondarily reported record
The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.
Should not be populated if primarySource = True, will not be required even if primarySource = False.
The source of the data for a record which is not from a primary source.
.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
The service delivery location where the vaccine administration occurred.
RXA-27 (or RXA-11, deprecated as of v2.7)
Body site where vaccine was administered.
The site at which the vaccine was administered
The path by which the vaccine product is taken into the body.
The route by which the vaccine was administered
The quantity of vaccine product that was administered.
Indicates who or what performed the event.
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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Describes the type of performance (e.g. ordering provider, administering provider, etc.).
The role a practitioner plays in the immunization event
The device, practitioner, etc. who performed the action.
Extra information about the immunization that is not conveyed by the other attributes.
Administration/non-administration reasons
Reasons why a vaccine was or was not administered.
The reason why a vaccine was administered
Reason why a vaccine was not administered.
The reason why a vaccine was not administered
Details of a reaction that follows immunization
Categorical data indicating that an adverse event is associated in time to an immunization.
A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new [AllergyIntolerance](http://hl7.org/fhir/STU3/allergyintolerance.html) resource instance as most systems will not query against past Immunization.reaction elements.
OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all)
(no such concept seems to exist for allergy/adverse reaction in HL7 v2)
.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
Contains information about the protocol(s) under which the vaccine was administered.
(HL7 v2 doesn't seem to provide for this)
Contains the description about the protocol under which the vaccine was administered.
Indicates the authority who published the protocol. E.g. ACIP.
One possible path to achieve presumed immunity against a disease - within the context of an authority.
Recommended number of doses for immunity
The recommended number of doses to achieve immunity.
The disease target of the vaccination protocol
Indicates if dose counts towards immunity
Indicates if the immunization event should "count" against the protocol.
May need to differentiate between status declarations by a provider vs. a CDS engine.
The status of the vaccination protocol (i.e. should this count)
Provides an explanation as to why an immunization event should or should not count against the protocol.
The reason for the determining if a vaccination should count or why vaccination should not count.