{
"description": "Immunization can be defined as “Generating natural immunity against pathogens by means of vaccination (active immunization) or by administering immunoglobulins (passive immunization)”.\\r\\n\\r\\nOnly the (administered and planned) vaccinations are included in this information model. Administering immunoglobulins is part of the medication overview. Vaccinations have lifelong relevance.\\r\\n\\r\\nMost vaccinations are carried out in the Netherlands as part of the RVP (Rijksvaccinatieprogramma, National Immunisation Program). RVP information is especially important for children.\\r\\n\\r\\nVaccinations are also relevant for adult patients such as transplant patients, dialysis patients and patients with a post-splenectomy status. In addition, there are specific indications for the vaccination of risk groups, such as travelers, professionals who come into contact with blood or patients with wounds, weakened immune systems or heightened risk.",
"_filename": "imm-Vaccination-event.json",
"package_name": "nictiz.fhir.nl.r4.immunization",
"date": "2024-06-20",
"derivation": "constraint",
"publisher": "Nictiz",
"fhirVersion": "4.0.1",
"purpose": "This Immunization resource represents the Vaccination building block for implementations following the information standard [Vaccination-Immunization](https://informatiestandaarden.nictiz.nl/wiki/imm:Landingspagina_Vaccinatie_Immunisatie). This profile is based on the Dutch zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) Immunization, but has no dependency on the corresponding nl-core profile because it contains non-compatible changes. Where compatible, mappings to zib concepts are defined. Additional concepts or concepts that are not compatible with their zib counterparts contain a mapping to the Vaccination-Immunization data set.",
"name": "ImmVaccinationevent",
"mapping": [ {
"uri": "https://decor.nictiz.nl/pub/immunisatie/imm-html-20240604T065227/ds-2.16.840.1.113883.2.4.3.11.60.131.1.1-2021-11-18T100634.html",
"name": "ART-DECOR Dataset Vaccination-Immunization 2.0.0-alpha.3 20240604",
"identity": "imm-dataset-200-alpha3-20240604"
}, {
"uri": "https://zibs.nl/wiki/Vaccination-v4.0(2020EN)",
"name": "zib Vaccination-v4.0(2020EN)",
"identity": "zib-vaccination-v4.0-2020EN"
} ],
"abstract": false,
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
"type": "Immunization",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "imm Vaccination event",
"package_version": "2.0.0-alpha.3",
"status": "draft",
"id": "43ea6b57-f1c6-44d4-9a10-bb34312d5ef5",
"kind": "resource",
"url": "http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event",
"version": "2.0.0-alpha.3",
"differential": {
"element": [ {
"id": "Immunization",
"path": "Immunization",
"comment": "All administered vaccinations are covered using this Immunization profile, while all planned vaccinations are covered in the [nl-core-Vaccination-request](http://nictiz.nl/fhir/StructureDefinition/nl-core-Vaccination-request) profile.\r\n\r\nPlease note that, contrary to the related zib concepts, `.vaccineCode` and `.occurrence[x]` are mandatory in FHIR and need to be recorded to exchange Immunization resources."
}, {
"id": "Immunization.extension:pharmaceuticalProduct",
"max": "1",
"path": "Immunization.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-imm-Vaccination.PharmaceuticalProduct" ]
} ],
"sliceName": "pharmaceuticalProduct"
}, {
"id": "Immunization.extension:pharmaceuticalProduct.value[x]",
"path": "Immunization.extension.value[x]",
"comment": "If this reference to ImmPharmaceuticalProduct is used, the MedicationCode (`Medication.code`) in the referenced resource SHALL be the same as `Immunization.vaccineCode` of the current resource.",
"definition": "The pharmaceutical product of the administered vaccination."
}, {
"id": "Immunization.identifier",
"path": "Immunization.identifier",
"alias": [ "Identificatienummer" ],
"short": "IdentificationNumber",
"mapping": [ {
"map": "imm-dataelement-135",
"comment": "IdentificationNumber",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"definition": "Globally unique number that identifies the instantiation of the information model. The number is composed of an identification of the issuer organization and a unique number assigned by this organization."
}, {
"id": "Immunization.status",
"path": "Immunization.status",
"alias": [ "StatusToediening" ],
"short": "AdministrationStatus",
"comment": "This element has no functional counterpart in the zib and cannot be implicitly mapped to other concepts. Unless a more appropriate status is recorded, it is assumed that only completed Immunization resources will be exchanged.",
"mapping": [ {
"map": "imm-dataelement-315",
"comment": "AdministrationStatus",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"definition": "Provides the administration status:\r\n* Not done: The event was terminated prior to any activity beyond preparation.\r\n* Entered in Error: This electronic record should never have existed, though it is possible that real-world decisions were based on it.\r\n* Completed: The event has now concluded."
}, {
"id": "Immunization.vaccineCode",
"path": "Immunization.vaccineCode",
"alias": [ "ProductCode" ],
"short": "ProductCode",
"binding": {
"strength": "extensible",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.131.11.7--20240507084413"
},
"comment": "A G-Standaard code is preferred over a SNOMED CT code. If both codes are available, a SNOMED CT code can be used as an alternative coding.\r\n\r\nEg. SNOMED CT code “871878002 | vaccin met uitsluitend antigenen van Corynebacterium diphtheriae, Bordetella pertussis, Clostridium tetani en humaan poliovirus (farmaceutisch product)” can be used as an alternative code for GPK code \"130745 | DKTP VACCIN (TRIAXIS POLIO)\". These concepts may differ slightly in the sense that the SNOMED code often is more generic compared to the G-Standaard code, but it may not be a different product.\r\n\r\nIt is possible to use a reference to imm PharmaceuticalProduct to identify the used vaccine, using `Immunization.extension:pharmaceuticalProduct`. If this reference is used, `Immunization.vaccineCode` SHALL contain the same value as the MedicationCode (`Medication.code`) in the referenced resource.",
"mapping": [ {
"map": "imm-dataelement-318",
"comment": "ProductCode",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"definition": "Coding medication in the Netherlands is done on the basis of the G-standaard (issued by Z-index), which is filled under the direction of Royal Dutch Pharmacists Association (KNMP). The coded medication can be expressed as:\r\n* ZI number\r\n* Trade product code (HPK)\r\n* Prescription code (PRK)\r\n* Generic product code (GPK)\r\n* SNOMED CT code\r\n\r\nThe ZI number represents the trade product and the package size. The HPK is the trade product as registered and marketed by the manufacturer.The PRK contains all GPK information supplemented with information needed to prescribe the right product. This level is intended to facilitate generic prescription of drugs. The GPK defines the pharmaceutical characteristics of a product: ingredients, strengths, units, pharmaceutical form and route of administration.Further information about the G-Standaard levels see https://www.z-index.nl. So-called 90.000.000 numbers are used in local IT systems. The 90.000.000 number is used in accordance with national agreements.\r\n\r\nSNOMED CT can be used as an alternative coding for a pharmaceutical product, for example it is used to describe the vaccinations from the Dutch National Immunisation Programme more generically based on the combination of substances (for example DKTP vaccine). With historical vaccines, a G-Standaard code is not always present, but it is recommended to record it for current processing. The SNOMED CT code for the same product can also be registered as an alternative."
}, {
"id": "Immunization.patient",
"path": "Immunization.patient",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient" ]
} ],
"alias": [ "Patient" ],
"short": "Patient",
"mapping": [ {
"map": "imm-dataelement-71",
"comment": "Patient",
"identity": "imm-dataset-200-alpha3-20240604"
} ]
}, {
"id": "Immunization.occurrence[x]",
"path": "Immunization.occurrence[x]",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "Immunization.occurrence[x]:occurrenceDateTime",
"path": "Immunization.occurrence[x]",
"type": [ {
"code": "dateTime"
} ],
"alias": [ "VaccinatieDatum" ],
"short": "VaccinationDate",
"mapping": [ {
"map": "NL-CM:11.1.3",
"comment": "VaccinationDate",
"identity": "zib-vaccination-v4.0-2020EN"
}, {
"map": "imm-dataelement-292",
"comment": "VaccinationDate",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"sliceName": "occurrenceDateTime",
"definition": "Date (and if possible time) that the vaccine was or will be administered. In the case of a planned re-vaccination, a vague date (month, year) is allowed (Clinical reminder). If a planned vaccination cannot be administered before a certain date, the date stated (vague or not) must indicate this."
}, {
"id": "Immunization.location",
"path": "Immunization.location",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location", "http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider" ]
} ],
"alias": [ "Locatie" ],
"short": "Location",
"comment": "Concept HealthcareProvider (imm-dataelement-262) is mapped to both `.location` and `.performer:administrator.actor`, to represent respectively the location where the vaccination was delivered (using [nl-core-HealthcareProvider](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider)) and the organization that delivered the vaccination (using [nl-core-HealthcareProvider-Organization](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization)).",
"mapping": [ {
"map": "imm-dataelement-262",
"comment": "HealthcareProvider",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"definition": "Physical location where the vaccination is or will be carried out."
}, {
"id": "Immunization.site",
"path": "Immunization.site",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/nl-core-AnatomicalLocation" ]
} ],
"alias": [ "AnatomischeLocatie", "Location" ],
"short": "AnatomicalLocation",
"binding": {
"strength": "extensible",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000"
},
"mapping": [ {
"map": "imm-dataelement-140",
"comment": "AnatomicalLocation",
"identity": "imm-dataset-200-alpha3-20240604"
} ]
}, {
"id": "Immunization.route",
"path": "Immunization.route",
"alias": [ "Toedieningsweg" ],
"short": "RouteOfAdministration",
"mapping": [ {
"map": "imm-dataelement-143",
"comment": "RouteOfAdministration",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"definition": "The route by which the vaccine is came into the body."
}, {
"id": "Immunization.doseQuantity",
"path": "Immunization.doseQuantity",
"alias": [ "Dosis" ],
"short": "Dose",
"comment": "The definition of Dose deviates slightly from the definition in the zib Vaccination; the unit of measure is not limited to mL. This difference is according to the planned modifications in the zib (https://bits.nictiz.nl/browse/ZIB-1654).",
"mapping": [ {
"map": "NL-CM:11.1.4",
"comment": "Dose",
"identity": "zib-vaccination-v4.0-2020EN"
}, {
"map": "imm-dataelement-291",
"comment": "Dose",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"definition": "The amount of product administered shown in milliliters. In most cases, the entire product is administered; in some cases, a described part of the product is administered."
}, {
"id": "Immunization.performer",
"path": "Immunization.performer",
"alias": [ "Toediener" ],
"short": "Performer",
"mapping": [ {
"map": "imm-dataelement-130",
"comment": "Performer",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "function",
"type": "value"
} ]
},
"definition": "The healthcare provider and/or organization where or by whom the vaccination was done or will be done."
}, {
"id": "Immunization.performer:administrator",
"path": "Immunization.performer",
"sliceName": "administrator"
}, {
"id": "Immunization.performer:administrator.actor",
"path": "Immunization.performer.actor",
"type": [ {
"code": "Reference",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/pattern-NlCoreHealthProfessionalReference" ],
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization", "http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole", "http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization" ]
} ],
"comment": "Each occurrence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [nl-core-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [nl-core-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner)). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.\r\n\r\nIn rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the zib-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.\r\n\r\nConcept HealthcareProvider (imm-dataelement-262) is mapped to both `.location` and `.performer:administrator.actor`, to represent respectively the location where the vaccination was delivered (using [nl-core-HealthcareProvider](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider)) and the organization that delivered the vaccination (using [nl-core-HealthcareProvider-Organization](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization)).",
"mapping": [ {
"map": "imm-dataelement-163",
"comment": "HealthcareProvider",
"identity": "imm-dataset-200-alpha3-20240604"
}, {
"map": "imm-dataelement-192",
"comment": "HealthProfessional",
"identity": "imm-dataset-200-alpha3-20240604"
} ]
}, {
"id": "Immunization.note.text",
"path": "Immunization.note.text",
"alias": [ "Toelichting" ],
"short": "Comment",
"mapping": [ {
"map": "NL-CM:11.1.7",
"comment": "Comment",
"identity": "zib-vaccination-v4.0-2020EN"
}, {
"map": "imm-dataelement-293",
"comment": "Comment",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"definition": "Free text explanation.\r\nExamples of commonly used explanations are: - \"Vaccination according to the National Immunisation Program\". - \"Not according to the National Immunisation Program\", followed by further explanation. - \"Unknown\""
}, {
"id": "Immunization.reasonCode",
"path": "Immunization.reasonCode",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "value"
} ]
}
}, {
"id": "Immunization.reasonCode:vaccinationIndication",
"path": "Immunization.reasonCode",
"alias": [ "VaccinatieIndicatie" ],
"short": "VaccinationIndication",
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.131.11.4--20220301181306"
},
"mapping": [ {
"map": "imm-dataelement-160",
"comment": "VaccinationIndication",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"sliceName": "vaccinationIndication",
"definition": "Displays the trigger based on what the vaccine was administered."
}, {
"id": "Immunization.reasonCode:vaccinationMotive",
"path": "Immunization.reasonCode",
"alias": [ "VaccinatieAanleiding" ],
"short": "VaccinationMotive",
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.131.11.2--20220301153357"
},
"mapping": [ {
"map": "imm-dataelement-158",
"comment": "VaccinationMotive",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"sliceName": "vaccinationMotive",
"definition": "Displays the trigger based on what the vaccine was administered."
}, {
"id": "Immunization.protocolApplied.targetDisease",
"path": "Immunization.protocolApplied.targetDisease",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "value"
} ]
}
}, {
"id": "Immunization.protocolApplied.targetDisease:targetDisease",
"path": "Immunization.protocolApplied.targetDisease",
"alias": [ "ZiekteWaarTegenGevaccineerdWordt" ],
"short": "VaccinationPathogen",
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.131.11.3--20220301175614"
},
"mapping": [ {
"map": "imm-dataelement-159",
"comment": "VaccinationPathogen",
"identity": "imm-dataset-200-alpha3-20240604"
} ],
"sliceName": "targetDisease",
"definition": "The disease or pathogeen against what the vaccination is primarily given."
} ]
},
"contact": [ {
"name": "Nictiz",
"telecom": [ {
"use": "work",
"value": "https://www.nictiz.nl",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization"
}