This page is part of a downloaded copy of this specification. This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU). For a full list of available versions, see the Directory of published versions 
| Public Health and Emergency Response Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Patient, Practitioner |
Raw JSON (canonical form + also see JSON Format Specification)
Example where the provider indicates the protocol being followed
{
"resourceType": "Immunization",
"id": "protocol",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: protocol</p><p><b>identifier</b>: urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p><p><b>status</b>: completed</p><p><b>vaccineCode</b>: Twinrix (HepA/HepB) <span>(Details : {http://hl7.org/fhir/sid/cvx code '104' = 'Hep A-Hep B)</span></p><p><b>patient</b>: <a>Patient/example</a></p><p><b>encounter</b>: <a>Encounter/example</a></p><p><b>occurrence</b>: 18/06/2018</p><p><b>primarySource</b>: true</p><p><b>location</b>: <a>Location/1</a></p><p><b>manufacturer</b>: <a>Organization/hl7</a></p><p><b>lotNumber</b>: PT123F</p><p><b>expirationDate</b>: 15/12/2018</p><p><b>site</b>: left arm <span>(Details : {http://terminology.hl7.org/CodeSystem/v3-ActSite code 'LA' = 'left arm', given as 'left arm'})</span></p><p><b>route</b>: Injection, intramuscular <span>(Details : {http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration code 'IM' = 'Injection, intramuscular', given as 'Injection, intramuscular'})</span></p><p><b>doseQuantity</b>: 5 mg<span> (Details: UCUM code mg = 'mg')</span></p><blockquote><p><b>performer</b></p><p><b>function</b>: Ordering Provider <span>(Details : {http://terminology.hl7.org/CodeSystem/v2-0443 code 'OP' = 'Ordering Provider)</span></p><p><b>actor</b>: <a>Practitioner/example</a></p></blockquote><blockquote><p><b>performer</b></p><p><b>function</b>: Administering Provider <span>(Details : {http://terminology.hl7.org/CodeSystem/v2-0443 code 'AP' = 'Administering Provider)</span></p><p><b>actor</b>: <a>Practitioner/example</a></p></blockquote><p><b>isSubpotent</b>: false</p><p><b>programEligibility</b>: Not Eligible <span>(Details : {http://terminology.hl7.org/CodeSystem/immunization-program-eligibility code 'ineligible' = 'Not Eligible)</span></p><p><b>fundingSource</b>: Private <span>(Details : {http://terminology.hl7.org/CodeSystem/immunization-funding-source code 'private' = 'Private)</span></p><blockquote><p><b>protocolApplied</b></p><p><b>series</b>: 2-dose</p><p><b>targetDisease</b>: Viral hepatitis, type A <span>(Details : {SNOMED CT code '40468003' = 'Viral hepatitis, type A)</span></p><p><b>doseNumber</b>: 1</p></blockquote><blockquote><p><b>protocolApplied</b></p><p><b>series</b>: 3-dose</p><p><b>targetDisease</b>: Type B viral hepatitis <span>(Details : {SNOMED CT code '66071002' = 'Type B viral hepatitis)</span></p><p><b>doseNumber</b>: 2</p></blockquote></div>"
},
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"
}
],
"status": "completed",
"vaccineCode": {
"coding": [
{
"system": "http://hl7.org/fhir/sid/cvx",
"code": "104"
}
],
"text": "Twinrix (HepA/HepB)"
},
"patient": {
"reference": "Patient/example"
},
"encounter": {
"reference": "Encounter/example"
},
"occurrenceDateTime": "2018-06-18",
"primarySource": true,
"location": {
"reference": "Location/1"
},
"manufacturer": {
"reference": "Organization/hl7"
},
"lotNumber": "PT123F",
"expirationDate": "2018-12-15",
"site": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActSite",
"code": "LA",
"display": "left arm"
}
]
},
"route": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration",
"code": "IM",
"display": "Injection, intramuscular"
}
]
},
"doseQuantity": {
"value": 5,
"system": "http://unitsofmeasure.org",
"code": "mg"
},
"performer": [
{
"function": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0443",
"code": "OP"
}
]
},
"actor": {
"reference": "Practitioner/example"
}
},
{
"function": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0443",
"code": "AP"
}
]
},
"actor": {
"reference": "Practitioner/example"
}
}
],
"isSubpotent": false,
"programEligibility": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/immunization-program-eligibility",
"code": "ineligible"
}
]
}
],
"fundingSource": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/immunization-funding-source",
"code": "private"
}
]
},
"protocolApplied": [
{
"series": "2-dose",
"targetDisease": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "40468003"
}
]
}
],
"doseNumberPositiveInt": 1
},
{
"series": "3-dose",
"targetDisease": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "66071002"
}
]
}
],
"doseNumberPositiveInt": 2
}
]
}
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.