ImmunizationEvaluation

Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations.

Schema

Elements

Name	Required	Type	Description
identifier		Identifier[]	Business identifier Details A unique identifier assigned to this immunization evaluation record.
status	✓	code	completed | entered-in-error Details Indicates the current status of the evaluation of the vaccination administration event.
patient	✓	Reference<Patient>	Who this evaluation is for Details The individual for whom the evaluation is being done.
date		dateTime	Date evaluation was performed Details The date the evaluation of the vaccine administration event was performed.
authority		Reference<Organization>	Who is responsible for publishing the recommendations Details Indicates the authority who published the protocol (e.g. ACIP).
targetDisease	✓	CodeableConcept	Evaluation target disease Details The vaccine preventable disease the dose is being evaluated against.
immunizationEvent	✓	Reference<Immunization>	Immunization being evaluated Details The vaccine administration event being evaluated.
doseStatus	✓	CodeableConcept	Status of the dose relative to published recommendations Details Indicates if the dose is valid or not valid with respect to the published recommendations.
doseStatusReason		CodeableConcept[]	Reason for the dose status Details Provides an explanation as to why the vaccine administration event is valid or not relative to the published recommendations.
description		string	Evaluation notes Details Additional information about the evaluation.
series		string	Name of vaccine series Details One possible path to achieve presumed immunity against a disease - within the context of an authority.
doseNumber[x]		positiveInt, string	Dose number within series Details Nominal position in a series. 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).
seriesDoses[x]		positiveInt, string	Recommended number of doses for immunity Details The recommended number of doses to achieve immunity. 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).

Search Parameters

Name	Type	Description	Expression
date	date	Date the evaluation was generated	ImmunizationEvaluation.date
dose-status	token	The status of the dose relative to published recommendations	ImmunizationEvaluation.doseStatus
identifier	token	ID of the evaluation	ImmunizationEvaluation.identifier
immunization-event	reference	The vaccine administration event being evaluated	ImmunizationEvaluation.immunizationEvent
patient	reference	The patient being evaluated	ImmunizationEvaluation.patient
status	token	Immunization evaluation status	ImmunizationEvaluation.status
target-disease	token	The vaccine preventable disease being evaluated against	ImmunizationEvaluation.targetDisease

Inherited Elements

Name	Required	Type	Description
id		string	Logical id of this artifact Details The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
meta		Meta	Metadata about the resource Details 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.
implicitRules		uri	A set of rules under which this content was created Details 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. 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.
language		code	Language of the resource content Details The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
text		Narrative	Text summary of the resource, for human interpretation Details 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. 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.
contained		Resource[]	Contained, inline Resources Details These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored Details 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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.

Usage

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.

Relationships

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.

Background and Context

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.

Referenced By

• ImmunizationRecommendation