PackagesCanonicalsLogsProblems
    Packages
    hl7.fhir.uv.ips@0.3.0
    http://hl7.org/fhir/uv/ips/StructureDefinition/Immunization-uv-ips
{
  "description": "This profile represents the constraints applied to the Immunization resource by the International Patient Summary (IPS) FHIR Implementation Guide. A record of an immunization is represented in the patient summary as an instance of an Immunization resource constrained by this profile.\\r\\n\\r\\nIt 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.",
  "_filename": "StructureDefinition-Immunization-uv-ips.json",
  "package_name": "hl7.fhir.uv.ips",
  "date": "2018-03-06T00:00:00-05:00",
  "derivation": "constraint",
  "meta": {
    "lastUpdated": "2018-03-07T12:47:01.502-05:00"
  },
  "publisher": null,
  "fhirVersion": "4.0.0",
  "jurisdiction": [ {
    "coding": [ {
      "code": "001",
      "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "display": "World"
    } ]
  } ],
  "purpose": "This profile constrains the representation of a record of a vaccination of the patient, in the context of the international patient summary as specified by the IPS project of HL7 International.",
  "name": "ImmunizationUvIps",
  "mapping": [ {
    "uri": "http://hl7.org/fhir/workflow",
    "name": "Workflow Pattern",
    "identity": "workflow"
  }, {
    "uri": "http://hl7.org/v2",
    "name": "HL7 v2 Mapping",
    "identity": "v2"
  }, {
    "uri": "http://hl7.org/v3",
    "name": "RIM Mapping",
    "identity": "rim"
  }, {
    "uri": "http://hl7.org/fhir/fivews",
    "name": "FiveWs Pattern Mapping",
    "identity": "w5"
  }, {
    "uri": "http://hl7.org/v3/cda",
    "name": "CDA (R2)",
    "identity": "cda"
  } ],
  "abstract": false,
  "type": "Immunization",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": "Immunization (IPS)",
  "package_version": "0.3.0",
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-3",
        "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",
        "xpath": "not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "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()"
      }, {
        "key": "dom-6",
        "human": "A resource should have narrative for robust management",
        "xpath": "exists(f:text/h:div)",
        "source": "DomainResource",
        "severity": "warning",
        "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."
        } ],
        "expression": "text.div.exists()"
      }, {
        "key": "dom-5",
        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.meta.security.empty()"
      } ],
      "path": "Immunization",
      "min": 0,
      "definition": "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",
      "isModifier": false,
      "short": "Immunization event information",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "Event",
        "identity": "workflow"
      }, {
        "map": "VXU_V04",
        "identity": "v2"
      }, {
        "map": "SubstanceAdministration",
        "identity": "rim"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Immunization",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization"
      },
      "isSummary": false
    }, {
      "path": "Immunization.id",
      "min": 0,
      "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
      "isModifier": false,
      "short": "Logical id of this artifact",
      "type": [ {
        "code": "id"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.id",
      "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.id"
      },
      "isSummary": true
    }, {
      "path": "Immunization.meta",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Metadata about the resource",
      "type": [ {
        "code": "Meta"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.meta",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.meta"
      },
      "isSummary": true
    }, {
      "path": "Immunization.meta.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.meta.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.meta.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.meta.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.meta.versionId",
      "min": 0,
      "definition": "The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.",
      "isModifier": false,
      "short": "Version specific identifier",
      "type": [ {
        "code": "id"
      } ],
      "max": "1",
      "id": "Immunization.meta.versionId",
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.versionId"
      },
      "isSummary": true
    }, {
      "path": "Immunization.meta.lastUpdated",
      "min": 0,
      "definition": "When the resource last changed - e.g. when the version changed.",
      "isModifier": false,
      "short": "When the resource version last changed",
      "type": [ {
        "code": "instant"
      } ],
      "max": "1",
      "id": "Immunization.meta.lastUpdated",
      "comment": "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. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R4/http.html#read) interaction.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.lastUpdated"
      },
      "isSummary": true
    }, {
      "path": "Immunization.meta.source",
      "min": 0,
      "definition": "A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.",
      "isModifier": false,
      "short": "Identifies where the resource comes from",
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Immunization.meta.source",
      "comment": "In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. \n\nThis element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.source"
      },
      "isSummary": true
    }, {
      "path": "Immunization.meta.profile",
      "min": 0,
      "definition": "A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).",
      "isModifier": false,
      "short": "Profiles this resource claims to conform to",
      "type": [ {
        "code": "canonical",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/StructureDefinition" ]
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Immunization.meta.profile",
      "comment": "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.",
      "fixedCanonical": "http://hl7.org/fhir/uv/ips/StructureDefinition/Immunization-uv-ips",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.profile"
      },
      "isSummary": true
    }, {
      "path": "Immunization.meta.security",
      "min": 0,
      "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
      "isModifier": false,
      "short": "Security Labels applied to this resource",
      "type": [ {
        "code": "Coding"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/security-labels",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "SecurityLabels"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "Security Labels from the Healthcare Privacy and Security Classification System."
      },
      "max": "*",
      "id": "Immunization.meta.security",
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.security"
      },
      "isSummary": true
    }, {
      "path": "Immunization.meta.tag",
      "min": 0,
      "definition": "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.",
      "isModifier": false,
      "short": "Tags applied to this resource",
      "type": [ {
        "code": "Coding"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/common-tags",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Tags"
        } ],
        "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\"."
      },
      "max": "*",
      "id": "Immunization.meta.tag",
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.tag"
      },
      "isSummary": true
    }, {
      "path": "Immunization.implicitRules",
      "min": 0,
      "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.",
      "isModifier": true,
      "short": "A set of rules under which this content was created",
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Immunization.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 it's narrative along with other profiles, value sets, etc.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.implicitRules"
      },
      "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
      "isSummary": true
    }, {
      "path": "Immunization.language",
      "min": 0,
      "definition": "The base language in which the resource is written.",
      "isModifier": false,
      "short": "Language of the resource content",
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/languages",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language."
      },
      "max": "1",
      "id": "Immunization.language",
      "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).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.language"
      },
      "isSummary": false
    }, {
      "path": "Immunization.text",
      "min": 0,
      "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.",
      "isModifier": false,
      "short": "Text summary of the resource, for human interpretation",
      "mapping": [ {
        "map": "Act.text?",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "alias": [ "narrative", "html", "xhtml", "display" ],
      "max": "1",
      "id": "Immunization.text",
      "comment": "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 information is added later.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "DomainResource.text"
      },
      "isSummary": false
    }, {
      "path": "Immunization.contained",
      "min": 0,
      "definition": "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.",
      "isModifier": false,
      "short": "Contained, inline Resources",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Resource"
      } ],
      "alias": [ "inline resources", "anonymous resources", "contained resources" ],
      "max": "*",
      "id": "Immunization.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.contained"
      },
      "isSummary": false
    }, {
      "path": "Immunization.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "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 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
      "isSummary": false
    }, {
      "path": "Immunization.identifier",
      "min": 0,
      "definition": "A unique identifier assigned to this immunization record.",
      "isModifier": false,
      "short": "Business identifier",
      "mapping": [ {
        "map": "Event.identifier",
        "identity": "workflow"
      }, {
        "map": "FiveWs.identifier",
        "identity": "w5"
      }, {
        "map": ".id",
        "identity": "rim"
      }, {
        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "*",
      "id": "Immunization.identifier",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.identifier"
      },
      "isSummary": false
    }, {
      "path": "Immunization.status",
      "min": 1,
      "definition": "Indicates the current status of the immunization event.",
      "isModifier": true,
      "short": "completed | entered-in-error | not-done",
      "mapping": [ {
        "map": "Event.status",
        "identity": "workflow"
      }, {
        "map": "FiveWs.status",
        "identity": "w5"
      }, {
        "map": "statusCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/immunization-status|4.0.0",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ImmunizationStatus"
        } ],
        "description": "A set of codes indicating the current status of an Immunization."
      },
      "max": "1",
      "id": "Immunization.status",
      "comment": "Will generally be set to show that the immunization has been completed or not done.  This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Immunization.status"
      },
      "isModifierReason": "This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid",
      "isSummary": true
    }, {
      "path": "Immunization.statusReason",
      "min": 0,
      "definition": "Indicates the reason the immunization event was not performed.",
      "isModifier": false,
      "short": "Reason not done",
      "mapping": [ {
        "map": "Event.statusReason",
        "identity": "workflow"
      }, {
        "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/immunization-status-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ImmunizationStatusReason"
        } ],
        "description": "The reason why a vaccine was not administered."
      },
      "max": "1",
      "id": "Immunization.statusReason",
      "comment": "This is generally only used for the status of \"not-done\". The reason for performing the immunization event is captured in reasonCode, not here.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.statusReason"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.vaccineCode",
      "min": 1,
      "definition": "Vaccine that was administered or was to be administered. Several kinds of vaccine product coding could be provided.\r\n\r\nThe IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent / unknown.\r\n\r\nOther coded information can be provided as well as:\r\n\r\n1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 1, [Substance(s)]. Example: Amoxicillin and Clavulanate Potassium; or any other equivalent coded concept;\r\n2. The IDMP Pharmaceutical Product Identifier (PhPID), Level 2 [Substance(s) + Strength + reference strength]. Example: Amoxicillin 875 mg and Clavulanate Potassium 125 mg; or any other equivalent coded concept;\r\n3. The IDMP Pharmaceutical Product Identifier (PhPID), Level 3 [Substance(s) + administrable dose form]. Example:  Amoxicillin and Clavulanate Potassium, Oral Tablet; or any other equivalent coded concept;\r\n4. The IDMP Pharmaceutical Product Identifier (PhPID), Level 4 [Substance(s) + strength + reference strength + administrable dose form]. Example: Amoxicillin 875 mg and clavulanate potassium 125 mg, oral tablet; or any other equivalent coded concept 5. The IDMP Medicinal Product Identifier (MPID) or any equivalent Medicinal Product Identifier. IDMP MPID uniquely identifies a Medicinal Product, reflecting (but not replacing) any other authorization numbers allocated by a regulator. MPID implies one (set of) PhPID. The MPID shall use a common segment pattern related to a Medicinal Product, which, when each segment is valued shall define a specific MPID concept.\r\n6. The IDMP Packaged Medicinal Product Identifier (PCID) or any equivalent Packaged Medicinal Product Identifier. Uniquely identifies a Medicinal Product based on its packaging. This implies one MPID can be associated with more than one PCID, if the same Medicinal Product has more than one type of package.\r\n7. Any other kind of code that that identifies, classifies or cluster the administered product (e.g. the medicinal product or the  product class)\r\n\r\nThe value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available.",
      "isModifier": false,
      "short": "Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided.\r\n\r\n     The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code.\r\n\r\n     Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO AC codes; or any other kind of code that that identifies, classifies or cluster the administered product.",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Discriminated by code system",
        "discriminator": [ {
          "path": "coding.system",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" ]
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips",
        "description": "The type of vaccine for particular disease or diseases against which the patient has been immunised."
      },
      "max": "1",
      "id": "Immunization.vaccineCode",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Immunization.vaccineCode"
      }
    }, {
      "path": "Immunization.vaccineCode.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.vaccineCode.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.vaccineCode.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.vaccineCode.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 1,
      "definition": "A representation of the vaccine in a code system. The representation can be granular or may also be a class or category.",
      "isModifier": false,
      "short": "A reference to a code defined by a terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Discriminated by code system",
        "discriminator": [ {
          "path": "system",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Coding",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/Coding-uv-ips" ]
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Immunization.vaccineCode.coding",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.vaccineCode.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 0,
      "definition": "WHO ATC classification",
      "isModifier": false,
      "short": "WHO ATC classification",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/Coding-uv-ips" ]
      } ],
      "mustSupport": true,
      "sliceName": "atcClass",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "WHO ATC"
        } ]
      },
      "max": "1",
      "id": "Immunization.vaccineCode.coding:atcClass",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      }
    }, {
      "path": "Immunization.vaccineCode.coding.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.vaccineCode.coding:atcClass.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.coding.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.vaccineCode.coding:atcClass.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 1,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "isModifier": false,
      "short": "Identity of the terminology system",
      "fixedUri": "http://www.whocc.no/atc",
      "mapping": [ {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.vaccineCode.coding:atcClass.system",
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.coding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "isModifier": false,
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.vaccineCode.coding:atcClass.version",
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 0,
      "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
      "isModifier": false,
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.vaccineCode.coding:atcClass.code",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "isModifier": false,
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Immunization.vaccineCode.coding:atcClass.display",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.coding.display.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references)",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.vaccineCode.coding:atcClass.display.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.coding.display.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Immunization.vaccineCode.coding:atcClass.display.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Immunization.vaccineCode.coding.display.extension",
      "min": 0,
      "definition": "Language translation from base language of resource to another language.",
      "isModifier": false,
      "short": "Language Translation (Localization)",
      "mapping": [ {
        "map": "ST.translation",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/translation" ]
      } ],
      "mustSupport": true,
      "sliceName": "translation",
      "max": "*",
      "id": "Immunization.vaccineCode.coding:atcClass.display.extension:translation",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "Immunization.vaccineCode.coding.display.value",
      "min": 0,
      "definition": "The actual value",
      "isModifier": false,
      "short": "Primitive value for string",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:string"
          } ]
        },
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/regex",
          "valueString": "[ \\r\\n\\t\\S]+"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.vaccineCode.coding:atcClass.display.value",
      "maxLength": 1048576,
      "base": {
        "max": "1",
        "min": 0,
        "path": "string.value"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
      "isModifier": false,
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Immunization.vaccineCode.coding:atcClass.userSelected",
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.text",
      "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
      "min": 0,
      "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
      "isModifier": false,
      "short": "Plain text representation of the concept",
      "mapping": [ {
        "map": "C*E.9. But note many systems use C*E.2 for this",
        "identity": "v2"
      }, {
        "map": "./originalText[mediaType/code=\"text/plain\"]/data",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Immunization.vaccineCode.text",
      "comment": "Very often the text is the same as a displayName of one of the codings.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "CodeableConcept.text"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.vaccineCode",
      "min": 0,
      "definition": "A reference to a code indicating that there there are no known immunizations or that this information is unknown.",
      "isModifier": false,
      "short": "Absent Unknown Immunization",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" ]
      } ],
      "mustSupport": true,
      "sliceName": "absentOrUnknownImmunization",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Absent Unknown Immunization"
        } ]
      },
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Immunization.vaccineCode"
      }
    }, {
      "path": "Immunization.vaccineCode.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.vaccineCode.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 1,
      "definition": "A reference to a code defined by a terminology system.",
      "isModifier": false,
      "short": "A reference to a code defined by a terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/Coding-uv-ips" ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      }
    }, {
      "path": "Immunization.vaccineCode.coding.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.coding.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 1,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "isModifier": false,
      "short": "Identity of the terminology system",
      "fixedUri": "http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips",
      "mapping": [ {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.system",
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.coding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "isModifier": false,
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.version",
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 0,
      "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
      "isModifier": false,
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.code",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "isModifier": false,
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.display",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.coding.display.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references)",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.display.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.coding.display.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.display.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Immunization.vaccineCode.coding.display.extension",
      "min": 0,
      "definition": "Language translation from base language of resource to another language.",
      "isModifier": false,
      "short": "Language Translation (Localization)",
      "mapping": [ {
        "map": "ST.translation",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/translation" ]
      } ],
      "mustSupport": true,
      "sliceName": "translation",
      "max": "*",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.display.extension:translation",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "Immunization.vaccineCode.coding.display.value",
      "min": 0,
      "definition": "The actual value",
      "isModifier": false,
      "short": "Primitive value for string",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:string"
          } ]
        },
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/regex",
          "valueString": "[ \\r\\n\\t\\S]+"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.display.value",
      "maxLength": 1048576,
      "base": {
        "max": "1",
        "min": 0,
        "path": "string.value"
      },
      "isSummary": false
    }, {
      "path": "Immunization.vaccineCode.coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
      "isModifier": false,
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.userSelected",
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "path": "Immunization.vaccineCode.text",
      "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
      "min": 0,
      "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
      "isModifier": false,
      "short": "Plain text representation of the concept",
      "mapping": [ {
        "map": "C*E.9. But note many systems use C*E.2 for this",
        "identity": "v2"
      }, {
        "map": "./originalText[mediaType/code=\"text/plain\"]/data",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.text",
      "comment": "The text should be at the displayName level and not on this level.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "CodeableConcept.text"
      },
      "isSummary": true
    }, {
      "path": "Immunization.patient",
      "min": 1,
      "definition": "The patient who either received or did not receive the immunization.",
      "isModifier": false,
      "short": "Who was immunized",
      "mapping": [ {
        "map": "Event.subject",
        "identity": "workflow"
      }, {
        "map": "FiveWs.subject[x]",
        "identity": "w5"
      }, {
        "map": "PID-3",
        "identity": "v2"
      }, {
        "map": ".partipication[ttypeCode=].role",
        "identity": "rim"
      }, {
        "map": "FiveWs.subject",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips" ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.patient",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Immunization.patient"
      },
      "isSummary": true
    }, {
      "path": "Immunization.patient.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.patient.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.patient.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.patient.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.patient.reference",
      "min": 1,
      "definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
      "isModifier": false,
      "short": "Literal reference, Relative, internal or absolute URL",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.patient.reference",
      "condition": [ "ref-1" ],
      "comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.reference"
      },
      "isSummary": true
    }, {
      "path": "Immunization.patient.type",
      "min": 0,
      "definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
      "isModifier": false,
      "short": "Type the reference refers to (e.g. \"Patient\")",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/resource-types",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "FHIRResourceTypeExt"
        } ],
        "description": "Aa resource (or, for logical models, the URI of the logical model)."
      },
      "max": "1",
      "id": "Immunization.patient.type",
      "comment": "This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.type"
      },
      "isSummary": true
    }, {
      "path": "Immunization.patient.identifier",
      "min": 0,
      "definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
      "isModifier": false,
      "short": "Logical reference, when literal reference is not known",
      "mapping": [ {
        "map": ".identifier",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "1",
      "id": "Immunization.patient.identifier",
      "comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.identifier"
      },
      "isSummary": true
    }, {
      "path": "Immunization.patient.display",
      "min": 0,
      "definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
      "isModifier": false,
      "short": "Text alternative for the resource",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Immunization.patient.display",
      "comment": "This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.display"
      },
      "isSummary": true
    }, {
      "path": "Immunization.encounter",
      "min": 0,
      "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
      "isModifier": false,
      "short": "Encounter immunization was part of",
      "mapping": [ {
        "map": "Event.context",
        "identity": "workflow"
      }, {
        "map": "FiveWs.context",
        "identity": "w5"
      }, {
        "map": "PV1-19",
        "identity": "v2"
      }, {
        "map": "component->EncounterEvent",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter" ]
      } ],
      "max": "1",
      "id": "Immunization.encounter",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.encounter"
      },
      "isSummary": false
    }, {
      "path": "Immunization.occurrence[x]",
      "min": 1,
      "definition": "Date vaccine administered or was to be administered.",
      "isModifier": false,
      "short": "Vaccine administration date",
      "mapping": [ {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "FiveWs.done[x]",
        "identity": "w5"
      }, {
        "map": "RXA-3",
        "identity": "v2"
      }, {
        "map": ".effectiveTime",
        "identity": "rim"
      }, {
        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "dateTime"
      }, {
        "code": "string"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.occurrence[x]",
      "comment": "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. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Immunization.occurrence[x]"
      },
      "isSummary": true
    }, {
      "path": "Immunization.occurrence[x].id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:string"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.occurrence[x].id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.occurrence[x].extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.occurrence[x].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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.occurrence[x].extension",
      "min": 0,
      "definition": "Provides a reason why the occurrence is missing.",
      "isModifier": false,
      "short": "occurrence[x] absence reason",
      "mapping": [ {
        "map": "ANY.nullFlavor",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
      } ],
      "mustSupport": true,
      "sliceName": "data-absent-reason",
      "max": "1",
      "id": "Immunization.occurrence[x].extension:data-absent-reason",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.occurrence[x].extension.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.occurrence[x].extension:data-absent-reason.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.occurrence[x].extension.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "0",
      "id": "Immunization.occurrence[x].extension:data-absent-reason.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.occurrence[x].extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "isModifier": false,
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.occurrence[x].extension:data-absent-reason.url",
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      },
      "isSummary": false
    }, {
      "path": "Immunization.occurrence[x].extension.valueCode",
      "min": 0,
      "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
      "isModifier": false,
      "short": "Value of extension",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.0",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "DataAbsentReason"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "Used to specify why the normally expected content of the data element is missing."
      },
      "max": "1",
      "id": "Immunization.occurrence[x].extension:data-absent-reason.valueCode",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      },
      "isSummary": false
    }, {
      "path": "Immunization.recorded",
      "min": 0,
      "definition": "The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.",
      "isModifier": false,
      "short": "When the immunization was first captured in the subject's record",
      "mapping": [ {
        "map": "FiveWs.recorded",
        "identity": "w5"
      }, {
        "map": ".participation[typeCode=AUT].time",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.recorded",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.recorded"
      },
      "isSummary": false
    }, {
      "path": "Immunization.primarySource",
      "min": 0,
      "definition": "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.",
      "isModifier": false,
      "short": "Indicates context the data was recorded in",
      "mapping": [ {
        "map": "FiveWs.source",
        "identity": "w5"
      }, {
        "map": "RXA-9",
        "identity": "v2"
      }, {
        "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.primarySource",
      "comment": "Reflects the “reliability” of the content.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.primarySource"
      },
      "isSummary": true
    }, {
      "path": "Immunization.reportOrigin",
      "min": 0,
      "definition": "The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.",
      "isModifier": false,
      "short": "Indicates the source of a secondarily reported record",
      "mapping": [ {
        "map": "FiveWs.source",
        "identity": "w5"
      }, {
        "map": "RXA-9",
        "identity": "v2"
      }, {
        "map": ".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)",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/immunization-origin",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ImmunizationReportOrigin"
        } ],
        "description": "The source of the data for a record which is not from a primary source."
      },
      "max": "1",
      "id": "Immunization.reportOrigin",
      "comment": "Should not be populated if primarySource = True, not required even if primarySource = False.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.reportOrigin"
      },
      "isSummary": false
    }, {
      "path": "Immunization.location",
      "min": 0,
      "definition": "The service delivery location where the vaccine administration occurred.",
      "isModifier": false,
      "short": "Where immunization occurred",
      "mapping": [ {
        "map": "Event.location",
        "identity": "workflow"
      }, {
        "map": "FiveWs.where[x]",
        "identity": "w5"
      }, {
        "map": "RXA-27  (or RXA-11, deprecated as of v2.7)",
        "identity": "v2"
      }, {
        "map": ".participation[typeCode=LOC].COCT_MT240000UV",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location" ]
      } ],
      "max": "1",
      "id": "Immunization.location",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.location"
      },
      "isSummary": false
    }, {
      "path": "Immunization.manufacturer",
      "min": 0,
      "definition": "Name of vaccine manufacturer.",
      "isModifier": false,
      "short": "Vaccine manufacturer",
      "mapping": [ {
        "map": "RXA-17",
        "identity": "v2"
      }, {
        "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]",
        "identity": "rim"
      }, {
        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "1",
      "id": "Immunization.manufacturer",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.manufacturer"
      },
      "isSummary": false
    }, {
      "path": "Immunization.lotNumber",
      "min": 0,
      "definition": "Lot number of the  vaccine product.",
      "isModifier": false,
      "short": "Vaccine lot number",
      "mapping": [ {
        "map": "RXA-15",
        "identity": "v2"
      }, {
        "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id",
        "identity": "rim"
      }, {
        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Immunization.lotNumber",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.lotNumber"
      },
      "isSummary": false
    }, {
      "path": "Immunization.expirationDate",
      "min": 0,
      "definition": "Date vaccine batch expires.",
      "isModifier": false,
      "short": "Vaccine expiration date",
      "mapping": [ {
        "map": "RXA-16",
        "identity": "v2"
      }, {
        "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "date"
      } ],
      "max": "1",
      "id": "Immunization.expirationDate",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.expirationDate"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.site",
      "min": 0,
      "definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
      "isModifier": false,
      "short": "Concept - reference to a terminology or just  text",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" ]
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/target-site-uv-ips"
      },
      "max": "1",
      "id": "Immunization.site",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.site"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.route",
      "min": 0,
      "definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
      "isModifier": false,
      "short": "Concept - reference to a terminology or just  text",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" ]
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ImmunizationRoute"
        } ]
      },
      "max": "1",
      "id": "Immunization.route",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.route"
      }
    }, {
      "path": "Immunization.doseQuantity",
      "min": 0,
      "definition": "The quantity of vaccine product that was administered.",
      "isModifier": false,
      "short": "Amount of vaccine administered",
      "mapping": [ {
        "map": "RXA-6 / RXA-7",
        "identity": "v2"
      }, {
        "map": ".doseQuantity",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "max": "1",
      "id": "Immunization.doseQuantity",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.doseQuantity"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.performer",
      "min": 0,
      "definition": "Indicates who performed the immunization event.",
      "isModifier": false,
      "short": "Who performed event",
      "mapping": [ {
        "map": "Event.performer",
        "identity": "workflow"
      }, {
        "map": "ORC-12 / RXA-10",
        "identity": "v2"
      }, {
        "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.performer",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.performer"
      },
      "isSummary": true
    }, {
      "path": "Immunization.performer.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.performer.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.performer.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.performer.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.performer.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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "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 manageable, 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).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Immunization.performer.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "Immunization.performer.function",
      "min": 0,
      "definition": "Describes the type of performance (e.g. ordering provider, administering provider, etc.).",
      "isModifier": false,
      "short": "What type of performance was done",
      "mapping": [ {
        "map": "Event.performer.function",
        "identity": "workflow"
      }, {
        "map": ".participation.functionCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/immunization-function",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ImmunizationFunction"
        } ],
        "description": "The role a practitioner or organization plays in the immunization event."
      },
      "max": "1",
      "id": "Immunization.performer.function",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.performer.function"
      },
      "isSummary": true
    }, {
      "path": "Immunization.performer.actor",
      "min": 1,
      "definition": "The practitioner or organization who performed the action.",
      "isModifier": false,
      "short": "Individual or organization who was performing",
      "mapping": [ {
        "map": "Event.performer.actor",
        "identity": "workflow"
      }, {
        "map": "FiveWs.actor",
        "identity": "w5"
      }, {
        "map": ".player",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.performer.actor",
      "comment": "When the individual practitioner who performed the action is known, it is best to send.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Immunization.performer.actor"
      },
      "isSummary": true
    }, {
      "path": "Immunization.performer.actor.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.performer.actor.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.performer.actor.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.performer.actor.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.performer.actor.reference",
      "min": 0,
      "definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
      "isModifier": false,
      "short": "Literal reference, Relative, internal or absolute URL",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Immunization.performer.actor.reference",
      "condition": [ "ref-1" ],
      "comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.reference"
      },
      "isSummary": true
    }, {
      "path": "Immunization.performer.actor.type",
      "min": 0,
      "definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
      "isModifier": false,
      "short": "Type the reference refers to (e.g. \"Patient\")",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/resource-types",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "FHIRResourceTypeExt"
        } ],
        "description": "Aa resource (or, for logical models, the URI of the logical model)."
      },
      "max": "1",
      "id": "Immunization.performer.actor.type",
      "comment": "This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.type"
      },
      "isSummary": true
    }, {
      "path": "Immunization.performer.actor.identifier",
      "min": 0,
      "definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
      "isModifier": false,
      "short": "Logical reference, when literal reference is not known",
      "mapping": [ {
        "map": ".identifier",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "1",
      "id": "Immunization.performer.actor.identifier",
      "comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.identifier"
      },
      "isSummary": true
    }, {
      "path": "Immunization.performer.actor.display",
      "min": 0,
      "definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
      "isModifier": false,
      "short": "Text alternative for the resource",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Immunization.performer.actor.display",
      "comment": "This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.display"
      },
      "isSummary": true
    }, {
      "path": "Immunization.note",
      "min": 0,
      "definition": "Extra information about the immunization that is not conveyed by the other attributes.",
      "isModifier": false,
      "short": "Additional immunization notes",
      "mapping": [ {
        "map": "Event.note",
        "identity": "workflow"
      }, {
        "map": "OBX-5 : OBX-3 = 48767-8",
        "identity": "v2"
      }, {
        "map": "note",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Annotation"
      } ],
      "max": "*",
      "id": "Immunization.note",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.note"
      },
      "isSummary": true
    }, {
      "path": "Immunization.reasonCode",
      "min": 0,
      "definition": "Reasons why the vaccine was administered.",
      "isModifier": false,
      "short": "Why immunization occurred",
      "mapping": [ {
        "map": "Event.reasonCode",
        "identity": "workflow"
      }, {
        "map": "[actionNegationInd=false].reasonCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/immunization-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ImmunizationReason"
        } ],
        "description": "The reason why a vaccine was administered."
      },
      "max": "*",
      "id": "Immunization.reasonCode",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.reasonCode"
      },
      "isSummary": false
    }, {
      "path": "Immunization.reasonReference",
      "min": 0,
      "definition": "Condition, Observation or DiagnosticReport that supports why the immunization was administered.",
      "isModifier": false,
      "short": "Why immunization occurred",
      "mapping": [ {
        "map": "Event.reasonReference",
        "identity": "workflow"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition", "http://hl7.org/fhir/StructureDefinition/Observation", "http://hl7.org/fhir/StructureDefinition/DiagnosticReport" ]
      } ],
      "max": "*",
      "id": "Immunization.reasonReference",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.reasonReference"
      },
      "isSummary": false
    }, {
      "path": "Immunization.isSubpotent",
      "min": 0,
      "definition": "Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.",
      "isModifier": true,
      "short": "Dose potency",
      "mapping": [ {
        "map": "RXA-20 = PA (partial administration)",
        "identity": "v2"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "meaningWhenMissing": "By default, a dose should be considered to be potent.",
      "max": "1",
      "id": "Immunization.isSubpotent",
      "comment": "Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.isSubpotent"
      },
      "isModifierReason": "This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.",
      "isSummary": true
    }, {
      "path": "Immunization.subpotentReason",
      "min": 0,
      "definition": "Reason why a dose is considered to be subpotent.",
      "isModifier": false,
      "short": "Reason for being subpotent",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/immunization-subpotent-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "SubpotentReason"
        } ],
        "description": "The reason why a dose is considered to be subpotent."
      },
      "max": "*",
      "id": "Immunization.subpotentReason",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.subpotentReason"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "imm-1",
        "human": "One of documentType or reference SHALL be present",
        "xpath": "exists(f:documentType) or exists(f:reference)",
        "severity": "error",
        "expression": "documentType.exists() or reference.exists()"
      } ],
      "path": "Immunization.education",
      "min": 0,
      "definition": "Educational material presented to the patient (or guardian) at the time of vaccine administration.",
      "isModifier": false,
      "short": "Educational material presented to patient",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Immunization.education",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.education"
      },
      "isSummary": false
    }, {
      "path": "Immunization.education.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.education.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.education.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.education.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.education.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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "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 manageable, 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).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Immunization.education.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "Immunization.education.documentType",
      "min": 0,
      "definition": "Identifier of the material presented to the patient.",
      "isModifier": false,
      "short": "Educational material document identifier",
      "mapping": [ {
        "map": "OBX-5 : OBX-3 = 69764-9",
        "identity": "v2"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Immunization.education.documentType",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.education.documentType"
      },
      "isSummary": false
    }, {
      "path": "Immunization.education.reference",
      "min": 0,
      "definition": "Reference pointer to the educational material given to the patient if the information was on line.",
      "isModifier": false,
      "short": "Educational material reference pointer",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Immunization.education.reference",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.education.reference"
      },
      "isSummary": false
    }, {
      "path": "Immunization.education.publicationDate",
      "min": 0,
      "definition": "Date the educational material was published.",
      "isModifier": false,
      "short": "Educational material publication date",
      "mapping": [ {
        "map": "OBX-5 : OBX-3 = 29768-9",
        "identity": "v2"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "max": "1",
      "id": "Immunization.education.publicationDate",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.education.publicationDate"
      },
      "isSummary": false
    }, {
      "path": "Immunization.education.presentationDate",
      "min": 0,
      "definition": "Date the educational material was given to the patient.",
      "isModifier": false,
      "short": "Educational material presentation date",
      "mapping": [ {
        "map": "OBX-5 : OBX-3 = 29769-7",
        "identity": "v2"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "max": "1",
      "id": "Immunization.education.presentationDate",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.education.presentationDate"
      },
      "isSummary": false
    }, {
      "path": "Immunization.programEligibility",
      "min": 0,
      "definition": "Indicates a patient's eligibility for a funding program.",
      "isModifier": false,
      "short": "Patient eligibility for a vaccination program",
      "mapping": [ {
        "map": "OBX-5 : OBX-3 = 64994-7",
        "identity": "v2"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/immunization-program-eligibility",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProgramEligibility"
        } ],
        "description": "The patient's eligibility for a vaccation program."
      },
      "max": "*",
      "id": "Immunization.programEligibility",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.programEligibility"
      },
      "isSummary": false
    }, {
      "path": "Immunization.fundingSource",
      "min": 0,
      "definition": "Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).",
      "isModifier": false,
      "short": "Funding source for the vaccine",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/immunization-funding-source",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "FundingSource"
        } ],
        "description": "The source of funding used to purchase the vaccine administered."
      },
      "max": "1",
      "id": "Immunization.fundingSource",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.fundingSource"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.reaction",
      "min": 0,
      "definition": "Categorical data indicating that an adverse event is associated in time to an immunization.",
      "isModifier": false,
      "short": "Details of a reaction that follows immunization",
      "mapping": [ {
        "map": "OBX-3",
        "identity": "v2"
      }, {
        "map": "Observation[classCode=obs].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Immunization.reaction",
      "comment": "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 resource instance as most systems will not query against past Immunization.reaction elements.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.reaction"
      },
      "isSummary": false
    }, {
      "path": "Immunization.reaction.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.reaction.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.reaction.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.reaction.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.reaction.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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "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 manageable, 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).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Immunization.reaction.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "Immunization.reaction.date",
      "min": 0,
      "definition": "Date of reaction to the immunization.",
      "isModifier": false,
      "short": "When reaction started",
      "mapping": [ {
        "map": "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)",
        "identity": "v2"
      }, {
        "map": ".effectiveTime",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "max": "1",
      "id": "Immunization.reaction.date",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.reaction.date"
      },
      "isSummary": false
    }, {
      "path": "Immunization.reaction.detail",
      "min": 0,
      "definition": "Details of the reaction.",
      "isModifier": false,
      "short": "Additional information on reaction",
      "mapping": [ {
        "map": "OBX-5",
        "identity": "v2"
      }, {
        "map": ".value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Observation" ]
      } ],
      "max": "1",
      "id": "Immunization.reaction.detail",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.reaction.detail"
      },
      "isSummary": false
    }, {
      "path": "Immunization.reaction.reported",
      "min": 0,
      "definition": "Self-reported indicator.",
      "isModifier": false,
      "short": "Indicates self-reported reaction",
      "mapping": [ {
        "map": "(HL7 v2 doesn't seem to provide for this)",
        "identity": "v2"
      }, {
        "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Immunization.reaction.reported",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.reaction.reported"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Immunization.protocolApplied",
      "min": 0,
      "definition": "The protocol (set of recommendations) being followed by the provider who administered the dose.",
      "isModifier": false,
      "short": "Protocol followed by the provider",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Immunization.protocolApplied",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.protocolApplied"
      },
      "isSummary": false
    }, {
      "path": "Immunization.protocolApplied.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Immunization.protocolApplied.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Immunization.protocolApplied.extension",
      "min": 0,
      "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 manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Immunization.protocolApplied.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Immunization.protocolApplied.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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "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 manageable, 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).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Immunization.protocolApplied.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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "Immunization.protocolApplied.series",
      "min": 0,
      "definition": "One possible path to achieve presumed immunity against a disease - within the context of an authority.",
      "isModifier": false,
      "short": "Name of vaccine series",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Immunization.protocolApplied.series",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.protocolApplied.series"
      },
      "isSummary": false
    }, {
      "path": "Immunization.protocolApplied.authority",
      "min": 0,
      "definition": "Indicates the authority who published the protocol (e.g. ACIP) that is being followed.",
      "isModifier": false,
      "short": "Who is responsible for publishing the recommendations",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "1",
      "id": "Immunization.protocolApplied.authority",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.protocolApplied.authority"
      },
      "isSummary": false
    }, {
      "path": "Immunization.protocolApplied.targetDisease",
      "min": 0,
      "definition": "The vaccine preventable disease the dose is being administered against.",
      "isModifier": false,
      "short": "Vaccine preventatable disease being targetted",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/immunization-target-disease",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "TargetDisease"
        } ],
        "description": "The vaccine preventable disease the dose is being administered for."
      },
      "max": "*",
      "id": "Immunization.protocolApplied.targetDisease",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Immunization.protocolApplied.targetDisease"
      },
      "isSummary": false
    }, {
      "path": "Immunization.protocolApplied.doseNumber[x]",
      "min": 1,
      "definition": "Nominal position in a series.",
      "isModifier": false,
      "short": "Dose number within series",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "positiveInt"
      }, {
        "code": "string"
      } ],
      "max": "1",
      "id": "Immunization.protocolApplied.doseNumber[x]",
      "comment": "The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Immunization.protocolApplied.doseNumber[x]"
      },
      "isSummary": false
    }, {
      "path": "Immunization.protocolApplied.seriesDoses[x]",
      "min": 0,
      "definition": "The recommended number of doses to achieve immunity.",
      "isModifier": false,
      "short": "Recommended number of doses for immunity",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "positiveInt"
      }, {
        "code": "string"
      } ],
      "max": "1",
      "id": "Immunization.protocolApplied.seriesDoses[x]",
      "comment": "The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Immunization.protocolApplied.seriesDoses[x]"
      },
      "isSummary": false
    } ]
  },
  "status": "draft",
  "id": "06a79459-090b-401e-8a1b-1753fddce398",
  "kind": "resource",
  "url": "http://hl7.org/fhir/uv/ips/StructureDefinition/Immunization-uv-ips",
  "version": "0.3.0",
  "differential": {
    "element": [ {
      "id": "Immunization",
      "path": "Immunization",
      "definition": "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",
      "mustSupport": true
    }, {
      "id": "Immunization.id",
      "path": "Immunization.id",
      "mustSupport": true
    }, {
      "id": "Immunization.meta",
      "path": "Immunization.meta",
      "mustSupport": true
    }, {
      "id": "Immunization.meta.profile",
      "path": "Immunization.meta.profile",
      "mustSupport": true,
      "fixedCanonical": "http://hl7.org/fhir/uv/ips/StructureDefinition/Immunization-uv-ips"
    }, {
      "id": "Immunization.status",
      "path": "Immunization.status",
      "mustSupport": true
    }, {
      "path": "Immunization.vaccineCode",
      "min": 1,
      "definition": "Vaccine that was administered or was to be administered. Several kinds of vaccine product coding could be provided.\r\n\r\nThe IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent / unknown.\r\n\r\nOther coded information can be provided as well as:\r\n\r\n1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 1, [Substance(s)]. Example: Amoxicillin and Clavulanate Potassium; or any other equivalent coded concept;\r\n2. The IDMP Pharmaceutical Product Identifier (PhPID), Level 2 [Substance(s) + Strength + reference strength]. Example: Amoxicillin 875 mg and Clavulanate Potassium 125 mg; or any other equivalent coded concept;\r\n3. The IDMP Pharmaceutical Product Identifier (PhPID), Level 3 [Substance(s) + administrable dose form]. Example:  Amoxicillin and Clavulanate Potassium, Oral Tablet; or any other equivalent coded concept;\r\n4. The IDMP Pharmaceutical Product Identifier (PhPID), Level 4 [Substance(s) + strength + reference strength + administrable dose form]. Example: Amoxicillin 875 mg and clavulanate potassium 125 mg, oral tablet; or any other equivalent coded concept 5. The IDMP Medicinal Product Identifier (MPID) or any equivalent Medicinal Product Identifier. IDMP MPID uniquely identifies a Medicinal Product, reflecting (but not replacing) any other authorization numbers allocated by a regulator. MPID implies one (set of) PhPID. The MPID shall use a common segment pattern related to a Medicinal Product, which, when each segment is valued shall define a specific MPID concept.\r\n6. The IDMP Packaged Medicinal Product Identifier (PCID) or any equivalent Packaged Medicinal Product Identifier. Uniquely identifies a Medicinal Product based on its packaging. This implies one MPID can be associated with more than one PCID, if the same Medicinal Product has more than one type of package.\r\n7. Any other kind of code that that identifies, classifies or cluster the administered product (e.g. the medicinal product or the  product class)\r\n\r\nThe value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available.",
      "short": "Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided.\r\n\r\n     The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code.\r\n\r\n     Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO AC codes; or any other kind of code that that identifies, classifies or cluster the administered product.",
      "slicing": {
        "rules": "open",
        "description": "Discriminated by code system",
        "discriminator": [ {
          "path": "coding.system",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" ]
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips",
        "description": "The type of vaccine for particular disease or diseases against which the patient has been immunised."
      },
      "max": "1",
      "id": "Immunization.vaccineCode"
    }, {
      "id": "Immunization.vaccineCode.coding",
      "min": 1,
      "path": "Immunization.vaccineCode.coding",
      "slicing": {
        "rules": "open",
        "description": "Discriminated by code system",
        "discriminator": [ {
          "path": "system",
          "type": "value"
        } ]
      },
      "definition": "A representation of the vaccine in a code system. The representation can be granular or may also be a class or category.",
      "mustSupport": true
    }, {
      "id": "Immunization.vaccineCode.coding:atcClass",
      "max": "1",
      "path": "Immunization.vaccineCode.coding",
      "short": "WHO ATC classification",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "WHO ATC"
        } ]
      },
      "sliceName": "atcClass",
      "definition": "WHO ATC classification",
      "mustSupport": true
    }, {
      "id": "Immunization.vaccineCode.coding:atcClass.system",
      "max": "1",
      "min": 1,
      "path": "Immunization.vaccineCode.coding.system",
      "fixedUri": "http://www.whocc.no/atc",
      "mustSupport": true
    }, {
      "path": "Immunization.vaccineCode",
      "min": 0,
      "definition": "A reference to a code indicating that there there are no known immunizations or that this information is unknown.",
      "short": "Absent Unknown Immunization",
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" ]
      } ],
      "mustSupport": true,
      "sliceName": "absentOrUnknownImmunization",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Absent Unknown Immunization"
        } ]
      },
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization"
    }, {
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding",
      "max": "1",
      "min": 1,
      "path": "Immunization.vaccineCode.coding",
      "mustSupport": true
    }, {
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.coding.system",
      "max": "1",
      "min": 1,
      "path": "Immunization.vaccineCode.coding.system",
      "fixedUri": "http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips",
      "mustSupport": true
    }, {
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization.text",
      "path": "Immunization.vaccineCode.text",
      "comment": "The text should be at the displayName level and not on this level.",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "mustSupport": true
    }, {
      "id": "Immunization.patient",
      "path": "Immunization.patient",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Immunization.patient.reference",
      "min": 1,
      "path": "Immunization.patient.reference",
      "mustSupport": true
    }, {
      "id": "Immunization.occurrence[x]",
      "max": "1",
      "min": 1,
      "path": "Immunization.occurrence[x]",
      "mustSupport": true
    }, {
      "id": "Immunization.occurrence[x].extension:data-absent-reason",
      "max": "1",
      "path": "Immunization.occurrence[x].extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
      } ],
      "short": "occurrence[x] absence reason",
      "sliceName": "data-absent-reason",
      "definition": "Provides a reason why the occurrence is missing.",
      "mustSupport": true
    }, {
      "id": "Immunization.recorded",
      "path": "Immunization.recorded",
      "mustSupport": true
    }, {
      "id": "Immunization.primarySource",
      "path": "Immunization.primarySource",
      "mustSupport": true
    }, {
      "id": "Immunization.reportOrigin",
      "path": "Immunization.reportOrigin",
      "mustSupport": true
    }, {
      "id": "Immunization.site",
      "path": "Immunization.site",
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" ]
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/target-site-uv-ips"
      },
      "mustSupport": true
    }, {
      "id": "Immunization.route",
      "path": "Immunization.route",
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" ]
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ImmunizationRoute"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "Immunization.performer",
      "max": "1",
      "path": "Immunization.performer",
      "mustSupport": true
    }, {
      "id": "Immunization.performer.actor",
      "path": "Immunization.performer.actor",
      "mustSupport": true
    }, {
      "id": "Immunization.performer.actor.reference",
      "path": "Immunization.performer.actor.reference",
      "mustSupport": true
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization"
}