This page is part of the FHIR Specification (v4.3.0: R4B - STU). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4
Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations.
The ImmunizationEvaluation resource is intended to cover communicating the results of an evaluation of a vaccine administration event (documented using the Immunization resource) against a set of published recommendations (protocols). Evaluating administered doses in a patient's immunization history is central to ensuring that the patient if fully protected against vaccine-preventable diseases. It is also a necessary prerequisite to generating a customized set of immunization recommendations for the patient.
The ImmunizationEvaluation resource communicates the results of an evaluation of an instance of the Immunization resource relative to a set of published recommendations. It is intended to communicate if the vaccine administration event was "valid" or "not valid" relative to the recommendations. Once all vaccine administration events in a patient's record have been evaluated, it is then possible to generate a set of vaccination related recommendations, unique for the patient. These recommendations are communicated using the ImmunizationRecommedation resource.
As the ImmunizationEvaluation resource is focused on the evaluation of a single vaccine administration event, it does not include data regarding the overall patient status relative to the recommendations used in the evaluation. For example, a total of 3 doses of hepatitis B vaccine may be required for patient protection, but an instance of the ImmunizationEvaluation resource will be concerned with only one of the doses (although other instances of ImmunizationEvaluation should exist for the other doses). The ImmunizationRecommendation resource is used to convey the overall patient status (eg. a dose is due or the patient is complete) relative to the hepatitis B series.
Through FHIR Release 3, the Immunization resource contained a "protocol" backbone element which functioned as an evaluation of the vaccine administration event. Beginning in Release 4, this new resource replaces the Immunization.protocol element.
This resource is referenced by ImmunizationRecommendation.
This resource implements the Event pattern.
Structure
| Name | Flags | Card. | Type | Description & Constraints doco |
|---|---|---|---|---|
| .. ImmunizationEvaluation | TU | DomainResource | Immunization evaluation information Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
| ... identifier | 0..* | Identifier | Business identifier | |
| ... status | ?! Σ | 1..1 | code | completed | entered-in-error Immunization Evaluation Status Codes (Required) |
| ... patient | Σ | 1..1 | Reference(Patient) | Who this evaluation is for |
| ... date | 0..1 | dateTime | Date evaluation was performed | |
| ... authority | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations | |
| ... targetDisease | Σ | 1..1 | CodeableConcept | Evaluation target disease Immunization Evaluation Target Disease Codes (Example) |
| ... immunizationEvent | Σ | 1..1 | Reference(Immunization) | Immunization being evaluated |
| ... doseStatus | Σ | 1..1 | CodeableConcept | Status of the dose relative to published recommendations Immunization Evaluation Dose Status codes (Example) |
| ... doseStatusReason | 0..* | CodeableConcept | Reason for the dose status Immunization Evaluation Dose Status Reason codes (Example) | |
| ... description | 0..1 | string | Evaluation notes | |
| ... series | 0..1 | string | Name of vaccine series | |
| ... doseNumber[x] | 0..1 | Dose number within series | ||
| .... doseNumberPositiveInt | positiveInt | |||
| .... doseNumberString | string | |||
| ... seriesDoses[x] | 0..1 | Recommended number of doses for immunity | ||
| .... seriesDosesPositiveInt | positiveInt | |||
| .... seriesDosesString | string | |||
doco Documentation for this format | ||||
UML Diagram (Legend)
XML Template
<ImmunizationEvaluation xmlns="http://hl7.org/fhir"> doco <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier Business identifier --></identifier> <status value="[code ]"/><!-- 1..1 completed | entered-in-error --> <patient><!-- 1..1 Reference(Patient) Who this evaluation is for --></patient> <date value="[dateTime ]"/><!-- 0..1 Date evaluation was performed --> <authority><!-- 0..1 Reference(Organization) Who is responsible for publishing the recommendations --></authority> <targetDisease><!-- 1..1 CodeableConcept Evaluation target disease --></targetDisease> <immunizationEvent><!-- 1..1 Reference(Immunization) Immunization being evaluated --></immunizationEvent> <doseStatus><!-- 1..1 CodeableConcept Status of the dose relative to published recommendations --></doseStatus> <doseStatusReason><!-- 0..* CodeableConcept Reason for the dose status --></doseStatusReason> <description value="[string ]"/><!-- 0..1 Evaluation notes --> <series value="[string ]"/><!-- 0..1 Name of vaccine series --> <doseNumber[x]><!-- 0..1 positiveInt|string Dose number within series --></doseNumber[x]> <seriesDoses[x]><!-- 0..1 positiveInt|string Recommended number of doses for immunity --></seriesDoses[x]> </ImmunizationEvaluation>
JSON Template
{doco
"resourceType" : "ImmunizationEvaluation",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Business identifier
"status" : "<code >", // R! completed | entered-in-error
"patient" : { Reference(Patient) }, // R! Who this evaluation is for
"date" : "<dateTime >", // Date evaluation was performed
"authority" : { Reference(Organization) }, // Who is responsible for publishing the recommendations
"targetDisease" : { CodeableConcept }, // R! Evaluation target disease
"immunizationEvent" : { Reference(Immunization) }, // R! Immunization being evaluated
"doseStatus" : { CodeableConcept }, // R! Status of the dose relative to published recommendations
"doseStatusReason" : [{ CodeableConcept }], // Reason for the dose status
"description" : "<string >", // Evaluation notes
"series" : "<string >", // Name of vaccine series
// doseNumber[x]: Dose number within series. One of these 2:
"doseNumberPositiveInt" : "<positiveInt >",
"doseNumberString" : "<string >",
// seriesDoses[x]: Recommended number of doses for immunity. One of these 2:
"seriesDosesPositiveInt" : "<positiveInt >"
"seriesDosesString" : "<string >"
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .doco [ a fhir:ImmunizationEvaluation; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from Resource: .id, .meta, .implicitRules, and .language # from DomainResource: .text, .contained, .extension, and .modifierExtension fhir:ImmunizationEvaluation.identifier[ Identifier ], ... ; # 0..* Business identifier fhir:ImmunizationEvaluation.status[ code ]; # 1..1 completed | entered-in-error fhir:ImmunizationEvaluation.patient[ Reference(Patient) ]; # 1..1 Who this evaluation is for fhir:ImmunizationEvaluation.date[ dateTime ]; # 0..1 Date evaluation was performed fhir:ImmunizationEvaluation.authority[ Reference(Organization) ]; # 0..1 Who is responsible for publishing the recommendations fhir:ImmunizationEvaluation.targetDisease[ CodeableConcept ]; # 1..1 Evaluation target disease fhir:ImmunizationEvaluation.immunizationEvent[ Reference(Immunization) ]; # 1..1 Immunization being evaluated fhir:ImmunizationEvaluation.doseStatus[ CodeableConcept ]; # 1..1 Status of the dose relative to published recommendations fhir:ImmunizationEvaluation.doseStatusReason[ CodeableConcept ], ... ; # 0..* Reason for the dose status fhir:ImmunizationEvaluation.description[ string ]; # 0..1 Evaluation notes fhir:ImmunizationEvaluation.series[ string ]; # 0..1 Name of vaccine series # ImmunizationEvaluation.doseNumber[x]: 0..1 Dose number within series. One of these 2 fhir:ImmunizationEvaluation.doseNumberPositiveInt[ positiveInt ] fhir:ImmunizationEvaluation.doseNumberString[ string ] # ImmunizationEvaluation.seriesDoses[x]: 0..1 Recommended number of doses for immunity. One of these 2 fhir:ImmunizationEvaluation.seriesDosesPositiveInt[ positiveInt ] fhir:ImmunizationEvaluation.seriesDosesString[ string ] ]
Changes since R4
See the Full Difference for further information
This analysis is available as XML or JSON.
Conversions between R3 and R4
Structure
| Name | Flags | Card. | Type | Description & Constraints doco |
|---|---|---|---|---|
| .. ImmunizationEvaluation | TU | DomainResource | Immunization evaluation information Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
| ... identifier | 0..* | Identifier | Business identifier | |
| ... status | ?! Σ | 1..1 | code | completed | entered-in-error Immunization Evaluation Status Codes (Required) |
| ... patient | Σ | 1..1 | Reference(Patient) | Who this evaluation is for |
| ... date | 0..1 | dateTime | Date evaluation was performed | |
| ... authority | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations | |
| ... targetDisease | Σ | 1..1 | CodeableConcept | Evaluation target disease Immunization Evaluation Target Disease Codes (Example) |
| ... immunizationEvent | Σ | 1..1 | Reference(Immunization) | Immunization being evaluated |
| ... doseStatus | Σ | 1..1 | CodeableConcept | Status of the dose relative to published recommendations Immunization Evaluation Dose Status codes (Example) |
| ... doseStatusReason | 0..* | CodeableConcept | Reason for the dose status Immunization Evaluation Dose Status Reason codes (Example) | |
| ... description | 0..1 | string | Evaluation notes | |
| ... series | 0..1 | string | Name of vaccine series | |
| ... doseNumber[x] | 0..1 | Dose number within series | ||
| .... doseNumberPositiveInt | positiveInt | |||
| .... doseNumberString | string | |||
| ... seriesDoses[x] | 0..1 | Recommended number of doses for immunity | ||
| .... seriesDosesPositiveInt | positiveInt | |||
| .... seriesDosesString | string | |||
doco Documentation for this format | ||||
UML Diagram (Legend)
XML Template
<ImmunizationEvaluation xmlns="http://hl7.org/fhir"> doco <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier Business identifier --></identifier> <status value="[code ]"/><!-- 1..1 completed | entered-in-error --> <patient><!-- 1..1 Reference(Patient) Who this evaluation is for --></patient> <date value="[dateTime ]"/><!-- 0..1 Date evaluation was performed --> <authority><!-- 0..1 Reference(Organization) Who is responsible for publishing the recommendations --></authority> <targetDisease><!-- 1..1 CodeableConcept Evaluation target disease --></targetDisease> <immunizationEvent><!-- 1..1 Reference(Immunization) Immunization being evaluated --></immunizationEvent> <doseStatus><!-- 1..1 CodeableConcept Status of the dose relative to published recommendations --></doseStatus> <doseStatusReason><!-- 0..* CodeableConcept Reason for the dose status --></doseStatusReason> <description value="[string ]"/><!-- 0..1 Evaluation notes --> <series value="[string ]"/><!-- 0..1 Name of vaccine series --> <doseNumber[x]><!-- 0..1 positiveInt|string Dose number within series --></doseNumber[x]> <seriesDoses[x]><!-- 0..1 positiveInt|string Recommended number of doses for immunity --></seriesDoses[x]> </ImmunizationEvaluation>
JSON Template
{doco
"resourceType" : "ImmunizationEvaluation",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Business identifier
"status" : "<code >", // R! completed | entered-in-error
"patient" : { Reference(Patient) }, // R! Who this evaluation is for
"date" : "<dateTime >", // Date evaluation was performed
"authority" : { Reference(Organization) }, // Who is responsible for publishing the recommendations
"targetDisease" : { CodeableConcept }, // R! Evaluation target disease
"immunizationEvent" : { Reference(Immunization) }, // R! Immunization being evaluated
"doseStatus" : { CodeableConcept }, // R! Status of the dose relative to published recommendations
"doseStatusReason" : [{ CodeableConcept }], // Reason for the dose status
"description" : "<string >", // Evaluation notes
"series" : "<string >", // Name of vaccine series
// doseNumber[x]: Dose number within series. One of these 2:
"doseNumberPositiveInt" : "<positiveInt >",
"doseNumberString" : "<string >",
// seriesDoses[x]: Recommended number of doses for immunity. One of these 2:
"seriesDosesPositiveInt" : "<positiveInt >"
"seriesDosesString" : "<string >"
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .doco [ a fhir:ImmunizationEvaluation; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from Resource: .id, .meta, .implicitRules, and .language # from DomainResource: .text, .contained, .extension, and .modifierExtension fhir:ImmunizationEvaluation.identifier[ Identifier ], ... ; # 0..* Business identifier fhir:ImmunizationEvaluation.status[ code ]; # 1..1 completed | entered-in-error fhir:ImmunizationEvaluation.patient[ Reference(Patient) ]; # 1..1 Who this evaluation is for fhir:ImmunizationEvaluation.date[ dateTime ]; # 0..1 Date evaluation was performed fhir:ImmunizationEvaluation.authority[ Reference(Organization) ]; # 0..1 Who is responsible for publishing the recommendations fhir:ImmunizationEvaluation.targetDisease[ CodeableConcept ]; # 1..1 Evaluation target disease fhir:ImmunizationEvaluation.immunizationEvent[ Reference(Immunization) ]; # 1..1 Immunization being evaluated fhir:ImmunizationEvaluation.doseStatus[ CodeableConcept ]; # 1..1 Status of the dose relative to published recommendations fhir:ImmunizationEvaluation.doseStatusReason[ CodeableConcept ], ... ; # 0..* Reason for the dose status fhir:ImmunizationEvaluation.description[ string ]; # 0..1 Evaluation notes fhir:ImmunizationEvaluation.series[ string ]; # 0..1 Name of vaccine series # ImmunizationEvaluation.doseNumber[x]: 0..1 Dose number within series. One of these 2 fhir:ImmunizationEvaluation.doseNumberPositiveInt[ positiveInt ] fhir:ImmunizationEvaluation.doseNumberString[ string ] # ImmunizationEvaluation.seriesDoses[x]: 0..1 Recommended number of doses for immunity. One of these 2 fhir:ImmunizationEvaluation.seriesDosesPositiveInt[ positiveInt ] fhir:ImmunizationEvaluation.seriesDosesString[ string ] ]
Changes since Release 4
See the Full Difference for further information
This analysis is available as XML or JSON.
Conversions between R3 and R4
See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis
| Path | Definition | Type | Reference |
|---|---|---|---|
| ImmunizationEvaluation.status | Required | ImmunizationEvaluationStatusCodes | |
| ImmunizationEvaluation.targetDisease | Example | ImmunizationEvaluationTargetDiseaseCodes | |
| ImmunizationEvaluation.doseStatus | Example | ImmunizationEvaluationDoseStatusCodes | |
| ImmunizationEvaluation.doseStatusReason | Example | ImmunizationEvaluationDoseStatusReasonCodes |
A single vaccine administration event (as communicated via the Immunization resource) may be evaluated against multiple published recommendations, against the same set of published recommendations at different points in time or against published recommendations for different vaccine-preventable diseases. That is a single Immunization record may be linked to multiple ImmunizationEvaluation records.
For example a dose of Twinrix contains antigen against both Hepatitis A and Hepatitis B. The evaluation of such a dose should happen against recommendations for both types of Hepatitis. Furthermore, the dose may be evaluated against both national and local recommendation or may be evaluated against either set of recommendations at multiple points in time (yearly as the patient comes in for standard "well person" appointment with their care provider).
Typically a single "recommendation" is prepared for the patient based on the evaluation of all of the vaccine administration events in the patient's history. This "recommendation" may include individual recommendations for multiple vaccines/vaccine groups. For example, a recommendation may be generated that includes recommendations for both influenza and diphtheria/tetanus vaccinations. Such recommendations use the ImmunizationRecommedation resource.
Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.