StructureDefinition-UKCore-Immunization

Canonical_URLCurrent_VersionLast_UpdatedDescription
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization2.4.02023-12-12

This profile defines the UK constraints and extensions on the International FHIR resource Immunization.


Profile_Purpose

This profile is intended to cover the recording of current and historical administration of vaccines to individuals across all healthcare disciplines in all care settings and all regions.

This profile does not support the administration of non-vaccine agents, even those that may have or claim to have immunological effects. While the terms "immunisation" and "vaccination" are not clinically identical, for the purposes of the FHIR profile, the terms are used synonymously.

Snapshot View

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
parentPresentI0..1Extension(boolean)
vaccinationProcedureI0..1Extension(CodeableConcept)
modifierExtension?! I0..*Extension
identifier0..*Identifier
statusS Σ ?!1..1codeBinding
statusReason0..1CodeableConceptBinding
vaccineCodeS Σ1..1CodeableConceptBinding
patientS Σ I1..1Reference(Patient)
encounterI0..1Reference(Encounter)
occurrenceDateTimedateTime
occurrenceStringstring
recorded0..1dateTime
primarySourceΣ0..1boolean
reportOrigin0..1CodeableConcept
locationI0..1Reference(Location)
manufacturerS I0..1Reference(Organization)
lotNumberS0..1string
expirationDate0..1date
site0..1CodeableConceptBinding
route0..1CodeableConceptBinding
doseQuantityS I0..1SimpleQuantity
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
functionΣ0..1CodeableConceptBinding
actorΣ I1..1Reference(Practitioner | PractitionerRole | Organization)
noteΣ0..*Annotation
reasonCode0..*CodeableConceptBinding
reasonReferenceI0..*Reference(Condition | Observation | DiagnosticReport)
isSubpotentΣ ?!0..1boolean
subpotentReason0..*CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
documentType0..1string
reference0..1uri
publicationDate0..1dateTime
presentationDate0..1dateTime
programEligibility0..*CodeableConcept
fundingSource0..1CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
date0..1dateTime
detailI0..1Reference(Observation)
reported0..1boolean
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
series0..1string
authorityI0..1Reference(Organization)
targetDisease0..*CodeableConcept
doseNumberPositiveIntpositiveInt
doseNumberStringstring
seriesDosesPositiveIntpositiveInt
seriesDosesStringstring

Differential View

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
parentPresentI0..1Extension(boolean)
vaccinationProcedureI0..1Extension(CodeableConcept)
modifierExtension?! I0..*Extension
identifier0..*Identifier
statusS Σ ?!1..1codeBinding
statusReason0..1CodeableConceptBinding
vaccineCodeS Σ1..1CodeableConceptBinding
patientS Σ I1..1Reference(Patient)
encounterI0..1Reference(Encounter)
occurrenceDateTimedateTime
occurrenceStringstring
recorded0..1dateTime
primarySourceΣ0..1boolean
reportOrigin0..1CodeableConcept
locationI0..1Reference(Location)
manufacturerS I0..1Reference(Organization)
lotNumberS0..1string
expirationDate0..1date
site0..1CodeableConceptBinding
route0..1CodeableConceptBinding
doseQuantityS I0..1SimpleQuantity
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
functionΣ0..1CodeableConceptBinding
actorΣ I1..1Reference(Practitioner | PractitionerRole | Organization)
noteΣ0..*Annotation
reasonCode0..*CodeableConceptBinding
reasonReferenceI0..*Reference(Condition | Observation | DiagnosticReport)
isSubpotentΣ ?!0..1boolean
subpotentReason0..*CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
documentType0..1string
reference0..1uri
publicationDate0..1dateTime
presentationDate0..1dateTime
programEligibility0..*CodeableConcept
fundingSource0..1CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
date0..1dateTime
detailI0..1Reference(Observation)
reported0..1boolean
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
series0..1string
authorityI0..1Reference(Organization)
targetDisease0..*CodeableConcept
doseNumberPositiveIntpositiveInt
doseNumberStringstring
seriesDosesPositiveIntpositiveInt
seriesDosesStringstring

Hybrid View

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
parentPresentI0..1Extension(boolean)
vaccinationProcedureI0..1Extension(CodeableConcept)
modifierExtension?! I0..*Extension
identifier0..*Identifier
statusS Σ ?!1..1codeBinding
statusReason0..1CodeableConceptBinding
vaccineCodeS Σ1..1CodeableConceptBinding
patientS Σ I1..1Reference(Patient)
encounterI0..1Reference(Encounter)
occurrenceDateTimedateTime
occurrenceStringstring
recorded0..1dateTime
primarySourceΣ0..1boolean
reportOrigin0..1CodeableConcept
locationI0..1Reference(Location)
manufacturerS I0..1Reference(Organization)
lotNumberS0..1string
expirationDate0..1date
site0..1CodeableConceptBinding
route0..1CodeableConceptBinding
doseQuantityS I0..1SimpleQuantity
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
functionΣ0..1CodeableConceptBinding
actorΣ I1..1Reference(Practitioner | PractitionerRole | Organization)
noteΣ0..*Annotation
reasonCode0..*CodeableConceptBinding
reasonReferenceI0..*Reference(Condition | Observation | DiagnosticReport)
isSubpotentΣ ?!0..1boolean
subpotentReason0..*CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
documentType0..1string
reference0..1uri
publicationDate0..1dateTime
presentationDate0..1dateTime
programEligibility0..*CodeableConcept
fundingSource0..1CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
date0..1dateTime
detailI0..1Reference(Observation)
reported0..1boolean
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
series0..1string
authorityI0..1Reference(Organization)
targetDisease0..*CodeableConcept
doseNumberPositiveIntpositiveInt
doseNumberStringstring
seriesDosesPositiveIntpositiveInt
seriesDosesStringstring

Table View

Immunization0..*
Immunization.idstring0..1
Immunization.metaMeta0..1
Immunization.implicitRulesuri0..1
Immunization.languagecode0..1
Immunization.textNarrative0..1
Immunization.containedResource0..*
Immunization.extensionExtension0..*
Immunization.extensionExtension0..1
Immunization.extensionExtension0..1
Immunization.modifierExtensionExtension0..*
Immunization.identifierIdentifier0..*
Immunization.statuscode1..1
Immunization.statusReasonCodeableConcept0..1
Immunization.vaccineCodeCodeableConcept1..1
Immunization.patientReference(Patient)1..1
Immunization.encounterReference(Encounter)0..1
Immunization.occurrence[x]dateTime, string1..1
Immunization.recordeddateTime0..1
Immunization.primarySourceboolean0..1
Immunization.reportOriginCodeableConcept0..1
Immunization.locationReference(Location)0..1
Immunization.manufacturerReference(Organization)0..1
Immunization.lotNumberstring0..1
Immunization.expirationDatedate0..1
Immunization.siteCodeableConcept0..1
Immunization.routeCodeableConcept0..1
Immunization.doseQuantitySimpleQuantity0..1
Immunization.performerBackboneElement0..*
Immunization.performer.idstring0..1
Immunization.performer.extensionExtension0..*
Immunization.performer.modifierExtensionExtension0..*
Immunization.performer.functionCodeableConcept0..1
Immunization.performer.actorReference(Practitioner | PractitionerRole | Organization)1..1
Immunization.noteAnnotation0..*
Immunization.reasonCodeCodeableConcept0..*
Immunization.reasonReferenceReference(Condition | Observation | DiagnosticReport)0..*
Immunization.isSubpotentboolean0..1
Immunization.subpotentReasonCodeableConcept0..*
Immunization.educationBackboneElement0..*
Immunization.education.idstring0..1
Immunization.education.extensionExtension0..*
Immunization.education.modifierExtensionExtension0..*
Immunization.education.documentTypestring0..1
Immunization.education.referenceuri0..1
Immunization.education.publicationDatedateTime0..1
Immunization.education.presentationDatedateTime0..1
Immunization.programEligibilityCodeableConcept0..*
Immunization.fundingSourceCodeableConcept0..1
Immunization.reactionBackboneElement0..*
Immunization.reaction.idstring0..1
Immunization.reaction.extensionExtension0..*
Immunization.reaction.modifierExtensionExtension0..*
Immunization.reaction.datedateTime0..1
Immunization.reaction.detailReference(Observation)0..1
Immunization.reaction.reportedboolean0..1
Immunization.protocolAppliedBackboneElement0..*
Immunization.protocolApplied.idstring0..1
Immunization.protocolApplied.extensionExtension0..*
Immunization.protocolApplied.modifierExtensionExtension0..*
Immunization.protocolApplied.seriesstring0..1
Immunization.protocolApplied.authorityReference(Organization)0..1
Immunization.protocolApplied.targetDiseaseCodeableConcept0..*
Immunization.protocolApplied.doseNumber[x]positiveInt, string1..1
Immunization.protocolApplied.seriesDoses[x]positiveInt, string0..1

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization" />
    <version value="2.4.0" />
    <name value="UKCoreImmunization" />
    <title value="UK Core Immunization" />
    <status value="active" />
    <date value="2023-12-12" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This profile defines the UK constraints and extensions on the International FHIR resource [Immunization](https://hl7.org/fhir/R4/Immunization.html)." />
    <purpose value="This profile is intended to cover the recording of current and historical administration of vaccines to individuals across all healthcare disciplines in all care settings and all regions. \n\nThis profile does not support the administration of non-vaccine agents, even those that may have or claim to have immunological effects. While the terms &quot;immunisation&quot; and &quot;vaccination&quot; are not clinically identical, for the purposes of the FHIR profile, the terms are used synonymously." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="Immunization" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Immunization" />
    <derivation value="constraint" />
    <snapshot>
        <element id="Immunization">
            <path value="Immunization" />
            <short value="Immunization event information" />
            <definition value="Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization" />
                <min value="0" />
                <max value="*" />
            </base>
            <constraint>
                <key value="dom-2" />
                <severity value="error" />
                <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
                <expression value="contained.contained.empty()" />
                <xpath value="not(parent::f:contained and f:contained)" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="dom-4" />
                <severity value="error" />
                <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
                <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
                <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="dom-3" />
                <severity value="error" />
                <human value="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" />
                <expression value="contained.where(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()" />
                <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
                    <valueBoolean value="true" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
                    <valueMarkdown value="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." />
                </extension>
                <key value="dom-6" />
                <severity value="warning" />
                <human value="A resource should have narrative for robust management" />
                <expression value="text.`div`.exists()" />
                <xpath value="exists(f:text/h:div)" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="dom-5" />
                <severity value="error" />
                <human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
                <expression value="contained.meta.security.empty()" />
                <xpath value="not(exists(f:contained/*/f:meta/f:security))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="ukcore-imm-001" />
                <severity value="error" />
                <human value="If the immunization was not given then Immunization.status value SHALL = &#39;not-done&#39;, and the Immunization.statusReason SHALL be populated" />
                <expression value="(status != &#39;not-done&#39;) or (status = &#39;not-done&#39; and statusReason.exists())" />
                <source value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="Entity. Role, or Act" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="VXU_V04" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="SubstanceAdministration" />
            </mapping>
        </element>
        <element id="Immunization.id">
            <path value="Immunization.id" />
            <short value="Logical id of this artifact" />
            <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
            <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isSummary value="true" />
        </element>
        <element id="Immunization.meta">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.meta" />
            <short value="Metadata about the resource" />
            <definition value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.meta" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Meta" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.implicitRules">
            <path value="Immunization.implicitRules" />
            <short value="A set of rules under which this content was created" />
            <definition value="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." />
            <comment value="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&#39;s narrative along with other profiles, value sets, etc." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.implicitRules" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.language">
            <path value="Immunization.language" />
            <short value="Language of the resource content" />
            <definition value="The base language in which the resource is written." />
            <comment value="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)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.language" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
                    <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Language" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="preferred" />
                <description value="A human language." />
                <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.text" />
            <short value="Text summary of the resource, for human interpretation" />
            <definition value="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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
            <comment value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later." />
            <alias value="narrative" />
            <alias value="html" />
            <alias value="xhtml" />
            <alias value="display" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="DomainResource.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Narrative" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act.text?" />
            </mapping>
        </element>
        <element id="Immunization.contained">
            <path value="Immunization.contained" />
            <short value="Contained, inline Resources" />
            <definition value="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." />
            <comment value="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." />
            <alias value="inline resources" />
            <alias value="anonymous resources" />
            <alias value="contained resources" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.contained" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Resource" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value="Entity. Role, or Act" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.extension:parentPresent">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.extension" />
            <sliceName value="parentPresent" />
            <short value="Was a parent of the patient present at an immunisation?" />
            <definition value="Was a parent of the patient present at an immunisation?" />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ParentPresent" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.extension:vaccinationProcedure">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.extension" />
            <sliceName value="vaccinationProcedure" />
            <short value="An extension to hold an immunization procedure code" />
            <definition value="An extension to hold an immunization procedure code." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-VaccinationProcedure" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.modifierExtension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.modifierExtension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extensions that cannot be ignored" />
            <definition value="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&#39;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)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.identifier">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.identifier" />
            <short value="Business identifier" />
            <definition value="A unique identifier assigned to this immunization record." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.identifier" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="Identifier" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.identifier" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.identifier" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".id" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id" />
            </mapping>
        </element>
        <element id="Immunization.status">
            <path value="Immunization.status" />
            <short value="completed | entered-in-error | not-done" />
            <definition value="Indicates the current status of the immunization event." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.status" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="true" />
            <isModifierReason value="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 value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationStatus" />
                </extension>
                <strength value="required" />
                <description value="A set of codes indicating the current status of an Immunization." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-status|4.0.1" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.status" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.status" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="statusCode" />
            </mapping>
        </element>
        <element id="Immunization.statusReason">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.statusReason" />
            <short value="Reason not done" />
            <definition value="Indicates the reason the immunization event was not performed." />
            <comment value="This is generally only used for the status of &quot;not-done&quot;. The reason for performing the immunization event is captured in reasonCode, not here." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.statusReason" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationStatusReason" />
                </extension>
                <strength value="preferred" />
                <description value="The reason why a vaccine was not administered." />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ReasonImmunizationNotAdministered" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.statusReason" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.vaccineCode" />
            <short value="Vaccine product administered" />
            <definition value="Vaccine that was administered or was to be administered." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.vaccineCode" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="VaccineCode" />
                </extension>
                <strength value="preferred" />
                <description value="The code for vaccine product administered." />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-VaccineCode" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.code" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.what[x]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".code" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code" />
            </mapping>
        </element>
        <element id="Immunization.patient">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.patient" />
            <short value="Who was immunized" />
            <definition value="The patient who either received or did not receive the immunization." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.patient" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mustSupport value="true" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.subject" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.subject[x]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="PID-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".partipication[ttypeCode=].role" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.subject" />
            </mapping>
        </element>
        <element id="Immunization.encounter">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.encounter" />
            <short value="Encounter immunization was part of" />
            <definition value="The visit or admission or other contact between patient and health care provider the immunization was performed as part of." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.encounter" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.context" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.context" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="PV1-19" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="component-&gt;EncounterEvent" />
            </mapping>
        </element>
        <element id="Immunization.occurrence[x]">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.occurrence[x]" />
            <short value="Vaccine administration date" />
            <definition value="Date vaccine administered or was to be administered." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.occurrence[x]" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.occurrence[x]" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.done[x]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".effectiveTime" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value" />
            </mapping>
        </element>
        <element id="Immunization.recorded">
            <path value="Immunization.recorded" />
            <short value="When the immunization was first captured in the subject&#39;s record" />
            <definition value="The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.recorded" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.recorded" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=AUT].time" />
            </mapping>
        </element>
        <element id="Immunization.primarySource">
            <path value="Immunization.primarySource" />
            <short value="Indicates context the data was recorded in" />
            <definition value="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." />
            <comment value="Reflects the “reliability” of the content." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.primarySource" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.source" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="immunization.uncertaintycode (if primary source=false, uncertainty=U)" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.reportOrigin" />
            <short value="Indicates the source of a secondarily reported record" />
            <definition value="The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine." />
            <comment value="Should not be populated if primarySource = True, not required even if primarySource = False." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.reportOrigin" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationReportOrigin" />
                </extension>
                <strength value="example" />
                <description value="The source of the data for a record which is not from a primary source." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-origin" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.source" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".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)" />
            </mapping>
        </element>
        <element id="Immunization.location">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.location" />
            <short value="Where immunization occurred" />
            <definition value="The service delivery location where the vaccine administration occurred." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.location" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.location" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.where[x]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-27  (or RXA-11, deprecated as of v2.7)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=LOC].COCT_MT240000UV" />
            </mapping>
        </element>
        <element id="Immunization.manufacturer">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.manufacturer" />
            <short value="Vaccine manufacturer" />
            <definition value="Name of vaccine manufacturer." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.manufacturer" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mustSupport value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-17" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name" />
            </mapping>
        </element>
        <element id="Immunization.lotNumber">
            <path value="Immunization.lotNumber" />
            <short value="Vaccine lot number" />
            <definition value="Lot number of the  vaccine product." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.lotNumber" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-15" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText" />
            </mapping>
        </element>
        <element id="Immunization.expirationDate">
            <path value="Immunization.expirationDate" />
            <short value="Vaccine expiration date" />
            <definition value="Date vaccine batch expires." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.expirationDate" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="date" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-16" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime" />
            </mapping>
        </element>
        <element id="Immunization.site">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.site" />
            <short value="Body site vaccine  was administered" />
            <definition value="Body site where vaccine was administered." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.site" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationSite" />
                </extension>
                <strength value="preferred" />
                <description value="The site at which the vaccine was administered." />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationAdministrationBodySite" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXR-2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="observation.targetSiteCode" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code" />
            </mapping>
        </element>
        <element id="Immunization.route">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.route" />
            <short value="How vaccine entered body" />
            <definition value="The path by which the vaccine product is taken into the body." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.route" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationRoute" />
                </extension>
                <strength value="preferred" />
                <description value="The route by which the vaccine was administered." />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXR-1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".routeCode" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code" />
            </mapping>
        </element>
        <element id="Immunization.doseQuantity">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.doseQuantity" />
            <short value="Amount of vaccine administered" />
            <definition value="The quantity of vaccine product that was administered." />
            <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.doseQuantity" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="qty-3" />
                <severity value="error" />
                <human value="If a code for the unit is present, the system SHALL also be present" />
                <expression value="code.empty() or system.exists()" />
                <xpath value="not(exists(f:code)) or exists(f:system)" />
                <source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
            </constraint>
            <constraint>
                <key value="sqty-1" />
                <severity value="error" />
                <human value="The comparator is not used on a SimpleQuantity" />
                <expression value="comparator.empty()" />
                <xpath value="not(exists(f:comparator))" />
                <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="SN (see also Range) or CQ" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-6 / RXA-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".doseQuantity" />
            </mapping>
        </element>
        <element id="Immunization.performer">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.performer" />
            <short value="Who performed event" />
            <definition value="Indicates who performed the immunization event." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.performer" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.performer" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="ORC-12 / RXA-10" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]" />
            </mapping>
        </element>
        <element id="Immunization.performer.id">
            <path value="Immunization.performer.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.performer.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.performer.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.performer.modifierExtension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.performer.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.performer.function">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.performer.function" />
            <short value="What type of performance was done" />
            <definition value="Describes the type of performance (e.g. ordering provider, administering provider, etc.)." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.performer.function" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationFunction" />
                </extension>
                <strength value="extensible" />
                <description value="The role a practitioner or organization plays in the immunization event." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-function" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.performer.function" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation.functionCode" />
            </mapping>
        </element>
        <element id="Immunization.performer.actor">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.performer.actor" />
            <short value="Individual or organization who was performing" />
            <definition value="The practitioner or organization who performed the action." />
            <comment value="When the individual practitioner who performed the action is known, it is best to send." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.performer.actor" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.performer.actor" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.actor" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".player" />
            </mapping>
        </element>
        <element id="Immunization.note">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.note" />
            <short value="Additional immunization notes" />
            <definition value="Extra information about the immunization that is not conveyed by the other attributes." />
            <comment value="For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate &quot;modifying&quot; information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible)." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.note" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Annotation" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.note" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 48767-8" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="note" />
            </mapping>
        </element>
        <element id="Immunization.reasonCode">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.reasonCode" />
            <short value="Why immunization occurred" />
            <definition value="Reasons why the vaccine was administered." />
            <comment value="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." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.reasonCode" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationReason" />
                </extension>
                <strength value="preferred" />
                <description value="The reason why a vaccine was administered." />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationExplanationReason" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.reasonCode" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="[actionNegationInd=false].reasonCode" />
            </mapping>
        </element>
        <element id="Immunization.reasonReference">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.reasonReference" />
            <short value="Why immunization occurred" />
            <definition value="Condition, Observation or DiagnosticReport that supports why the immunization was administered." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.reasonReference" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.reasonReference" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.isSubpotent">
            <path value="Immunization.isSubpotent" />
            <short value="Dose potency" />
            <definition value="Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.isSubpotent" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <meaningWhenMissing value="By default, a dose should be considered to be potent." />
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn&#39;t protect the patient the same way as a potent dose." />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-20 = PA (partial administration)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.subpotentReason">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.subpotentReason" />
            <short value="Reason for being subpotent" />
            <definition value="Reason why a dose is considered to be subpotent." />
            <comment value="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." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.subpotentReason" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="SubpotentReason" />
                </extension>
                <strength value="example" />
                <description value="The reason why a dose is considered to be subpotent." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-subpotent-reason" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.education" />
            <short value="Educational material presented to patient" />
            <definition value="Educational material presented to the patient (or guardian) at the time of vaccine administration." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.education" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="imm-1" />
                <severity value="error" />
                <human value="One of documentType or reference SHALL be present" />
                <expression value="documentType.exists() or reference.exists()" />
                <xpath value="exists(f:documentType) or exists(f:reference)" />
                <source value="http://hl7.org/fhir/StructureDefinition/Immunization" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.id">
            <path value="Immunization.education.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.education.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.education.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.modifierExtension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.education.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.documentType">
            <path value="Immunization.education.documentType" />
            <short value="Educational material document identifier" />
            <definition value="Identifier of the material presented to the patient." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.education.documentType" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 69764-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.reference">
            <path value="Immunization.education.reference" />
            <short value="Educational material reference pointer" />
            <definition value="Reference pointer to the educational material given to the patient if the information was on line." />
            <comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.education.reference" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.publicationDate">
            <path value="Immunization.education.publicationDate" />
            <short value="Educational material publication date" />
            <definition value="Date the educational material was published." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.education.publicationDate" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 29768-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.presentationDate">
            <path value="Immunization.education.presentationDate" />
            <short value="Educational material presentation date" />
            <definition value="Date the educational material was given to the patient." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.education.presentationDate" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 29769-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.programEligibility">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.programEligibility" />
            <short value="Patient eligibility for a vaccination program" />
            <definition value="Indicates a patient&#39;s eligibility for a funding program." />
            <comment value="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." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.programEligibility" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ProgramEligibility" />
                </extension>
                <strength value="example" />
                <description value="The patient&#39;s eligibility for a vaccation program." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-program-eligibility" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 64994-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.fundingSource">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.fundingSource" />
            <short value="Funding source for the vaccine" />
            <definition value="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)." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.fundingSource" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="FundingSource" />
                </extension>
                <strength value="example" />
                <description value="The source of funding used to purchase the vaccine administered." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-funding-source" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.reaction">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.reaction" />
            <short value="Details of a reaction that follows immunization" />
            <definition value="Categorical data indicating that an adverse event is associated in time to an immunization." />
            <comment value="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." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.reaction" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="OBX-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Observation[classCode=obs].code" />
            </mapping>
        </element>
        <element id="Immunization.reaction.id">
            <path value="Immunization.reaction.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.reaction.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.reaction.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.reaction.modifierExtension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.reaction.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.reaction.date">
            <path value="Immunization.reaction.date" />
            <short value="When reaction started" />
            <definition value="Date of reaction to the immunization." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.reaction.date" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="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)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".effectiveTime" />
            </mapping>
        </element>
        <element id="Immunization.reaction.detail">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.reaction.detail" />
            <short value="Additional information on reaction" />
            <definition value="Details of the reaction." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.reaction.detail" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="OBX-5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".value" />
            </mapping>
        </element>
        <element id="Immunization.reaction.reported">
            <path value="Immunization.reaction.reported" />
            <short value="Indicates self-reported reaction" />
            <definition value="Self-reported indicator." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.reaction.reported" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(HL7 v2 doesn&#39;t seem to provide for this)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.protocolApplied" />
            <short value="Protocol followed by the provider" />
            <definition value="The protocol (set of recommendations) being followed by the provider who administered the dose." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.protocolApplied" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.id">
            <path value="Immunization.protocolApplied.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.protocolApplied.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.modifierExtension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.protocolApplied.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.series">
            <path value="Immunization.protocolApplied.series" />
            <short value="Name of vaccine series" />
            <definition value="One possible path to achieve presumed immunity against a disease - within the context of an authority." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.protocolApplied.series" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.authority">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.protocolApplied.authority" />
            <short value="Who is responsible for publishing the recommendations" />
            <definition value="Indicates the authority who published the protocol (e.g. ACIP) that is being followed." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.protocolApplied.authority" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.targetDisease">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.protocolApplied.targetDisease" />
            <short value="Vaccine preventatable disease being targetted" />
            <definition value="The vaccine preventable disease the dose is being administered against." />
            <comment value="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." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.protocolApplied.targetDisease" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="TargetDisease" />
                </extension>
                <strength value="example" />
                <description value="The vaccine preventable disease the dose is being administered for." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-target-disease" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.doseNumber[x]">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.protocolApplied.doseNumber[x]" />
            <short value="Dose number within series" />
            <definition value="Nominal position in a series." />
            <comment value="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)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.protocolApplied.doseNumber[x]" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="positiveInt" />
            </type>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.seriesDoses[x]">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.protocolApplied.seriesDoses[x]" />
            <short value="Recommended number of doses for immunity" />
            <definition value="The recommended number of doses to achieve immunity." />
            <comment value="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)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.protocolApplied.seriesDoses[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="positiveInt" />
            </type>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
    </snapshot>
    <differential>
        <element id="Immunization">
            <path value="Immunization" />
            <constraint>
                <key value="ukcore-imm-001" />
                <severity value="error" />
                <human value="If the immunization was not given then Immunization.status value SHALL = &#39;not-done&#39;, and the Immunization.statusReason SHALL be populated" />
                <expression value="(status != &#39;not-done&#39;) or (status = &#39;not-done&#39; and statusReason.exists())" />
            </constraint>
        </element>
        <element id="Immunization.extension:parentPresent">
            <path value="Immunization.extension" />
            <sliceName value="parentPresent" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ParentPresent" />
            </type>
        </element>
        <element id="Immunization.extension:vaccinationProcedure">
            <path value="Immunization.extension" />
            <sliceName value="vaccinationProcedure" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-VaccinationProcedure" />
            </type>
        </element>
        <element id="Immunization.status">
            <path value="Immunization.status" />
            <mustSupport value="true" />
        </element>
        <element id="Immunization.statusReason">
            <path value="Immunization.statusReason" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ReasonImmunizationNotAdministered" />
            </binding>
        </element>
        <element id="Immunization.vaccineCode">
            <path value="Immunization.vaccineCode" />
            <mustSupport value="true" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-VaccineCode" />
            </binding>
        </element>
        <element id="Immunization.patient">
            <path value="Immunization.patient" />
            <mustSupport value="true" />
        </element>
        <element id="Immunization.occurrence[x]">
            <path value="Immunization.occurrence[x]" />
            <mustSupport value="true" />
        </element>
        <element id="Immunization.manufacturer">
            <path value="Immunization.manufacturer" />
            <mustSupport value="true" />
        </element>
        <element id="Immunization.lotNumber">
            <path value="Immunization.lotNumber" />
            <mustSupport value="true" />
        </element>
        <element id="Immunization.site">
            <path value="Immunization.site" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationAdministrationBodySite" />
            </binding>
        </element>
        <element id="Immunization.route">
            <path value="Immunization.route" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute" />
            </binding>
        </element>
        <element id="Immunization.doseQuantity">
            <path value="Immunization.doseQuantity" />
            <mustSupport value="true" />
        </element>
        <element id="Immunization.reasonCode">
            <path value="Immunization.reasonCode" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationExplanationReason" />
            </binding>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-Immunization",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization",
    "version": "2.4.0",
    "name": "UKCoreImmunization",
    "title": "UK Core Immunization",
    "status": "active",
    "date": "2023-12-12",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This profile defines the UK constraints and extensions on the International FHIR resource [Immunization](https://hl7.org/fhir/R4/Immunization.html).",
    "purpose": "This profile is intended to cover the recording of current and historical administration of vaccines to individuals across all healthcare disciplines in all care settings and all regions. \n\nThis profile does not support the administration of non-vaccine agents, even those that may have or claim to have immunological effects. While the terms \"immunisation\" and \"vaccination\" are not clinically identical, for the purposes of the FHIR profile, the terms are used synonymously.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Immunization",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization",
    "derivation": "constraint",
    "snapshot": {
        "element":  [
            {
                "id": "Immunization",
                "path": "Immunization",
                "short": "Immunization event information",
                "definition": "Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization",
                    "min": 0,
                    "max": "*"
                },
                "constraint":  [
                    {
                        "key": "dom-2",
                        "severity": "error",
                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
                        "expression": "contained.contained.empty()",
                        "xpath": "not(parent::f:contained and f:contained)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-4",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-3",
                        "severity": "error",
                        "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",
                        "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()",
                        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "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."
                            }
                        ],
                        "key": "dom-6",
                        "severity": "warning",
                        "human": "A resource should have narrative for robust management",
                        "expression": "text.`div`.exists()",
                        "xpath": "exists(f:text/h:div)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-5",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
                        "expression": "contained.meta.security.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "ukcore-imm-001",
                        "severity": "error",
                        "human": "If the immunization was not given then Immunization.status value SHALL = 'not-done', and the Immunization.statusReason SHALL be populated",
                        "expression": "(status != 'not-done') or (status = 'not-done' and statusReason.exists())",
                        "source": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Entity. Role, or Act"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event"
                    },
                    {
                        "identity": "v2",
                        "map": "VXU_V04"
                    },
                    {
                        "identity": "rim",
                        "map": "SubstanceAdministration"
                    }
                ]
            },
            {
                "id": "Immunization.id",
                "path": "Immunization.id",
                "short": "Logical id of this artifact",
                "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isSummary": true
            },
            {
                "id": "Immunization.meta",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.meta",
                "short": "Metadata about the resource",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.meta",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Meta"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.implicitRules",
                "path": "Immunization.implicitRules",
                "short": "A set of rules under which this content was created",
                "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.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.implicitRules",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "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,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.language",
                "path": "Immunization.language",
                "short": "Language of the resource content",
                "definition": "The base language in which the resource is written.",
                "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).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.language",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "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
                        }
                    ],
                    "strength": "preferred",
                    "description": "A human language.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.text",
                "short": "Text summary of the resource, for human interpretation",
                "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.",
                "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.",
                "alias":  [
                    "narrative",
                    "html",
                    "xhtml",
                    "display"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Narrative"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act.text?"
                    }
                ]
            },
            {
                "id": "Immunization.contained",
                "path": "Immunization.contained",
                "short": "Contained, inline Resources",
                "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.",
                "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.",
                "alias":  [
                    "inline resources",
                    "anonymous resources",
                    "contained resources"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.contained",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Resource"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Entity. Role, or Act"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.extension:parentPresent",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.extension",
                "sliceName": "parentPresent",
                "short": "Was a parent of the patient present at an immunisation?",
                "definition": "Was a parent of the patient present at an immunisation?",
                "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ParentPresent"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.extension:vaccinationProcedure",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.extension",
                "sliceName": "vaccinationProcedure",
                "short": "An extension to hold an immunization procedure code",
                "definition": "An extension to hold an immunization procedure code.",
                "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-VaccinationProcedure"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.modifierExtension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.modifierExtension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extensions that cannot be ignored",
                "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).",
                "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.identifier",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.identifier",
                "short": "Business identifier",
                "definition": "A unique identifier assigned to this immunization record.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.identifier",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
                    },
                    {
                        "identity": "rim",
                        "map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
                    },
                    {
                        "identity": "servd",
                        "map": "Identifier"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.identifier"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.identifier"
                    },
                    {
                        "identity": "rim",
                        "map": ".id"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id"
                    }
                ]
            },
            {
                "id": "Immunization.status",
                "path": "Immunization.status",
                "short": "completed | entered-in-error | not-done",
                "definition": "Indicates the current status of the immunization event.",
                "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.status",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": true,
                "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,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationStatus"
                        }
                    ],
                    "strength": "required",
                    "description": "A set of codes indicating the current status of an Immunization.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-status|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.status"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.status"
                    },
                    {
                        "identity": "rim",
                        "map": "statusCode"
                    }
                ]
            },
            {
                "id": "Immunization.statusReason",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.statusReason",
                "short": "Reason not done",
                "definition": "Indicates the reason the immunization event was not performed.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.statusReason",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationStatusReason"
                        }
                    ],
                    "strength": "preferred",
                    "description": "The reason why a vaccine was not administered.",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ReasonImmunizationNotAdministered"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.statusReason"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.vaccineCode",
                "short": "Vaccine product administered",
                "definition": "Vaccine that was administered or was to be administered.",
                "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.vaccineCode",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "VaccineCode"
                        }
                    ],
                    "strength": "preferred",
                    "description": "The code for vaccine product administered.",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-VaccineCode"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.code"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.what[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-5"
                    },
                    {
                        "identity": "rim",
                        "map": ".code"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code"
                    }
                ]
            },
            {
                "id": "Immunization.patient",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.patient",
                "short": "Who was immunized",
                "definition": "The patient who either received or did not receive the immunization.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.patient",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mustSupport": true,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.subject"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "PID-3"
                    },
                    {
                        "identity": "rim",
                        "map": ".partipication[ttypeCode=].role"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject"
                    }
                ]
            },
            {
                "id": "Immunization.encounter",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.encounter",
                "short": "Encounter immunization was part of",
                "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.encounter",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Encounter"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.context"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.context"
                    },
                    {
                        "identity": "v2",
                        "map": "PV1-19"
                    },
                    {
                        "identity": "rim",
                        "map": "component->EncounterEvent"
                    }
                ]
            },
            {
                "id": "Immunization.occurrence[x]",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.occurrence[x]",
                "short": "Vaccine administration date",
                "definition": "Date vaccine administered or was to be administered.",
                "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.occurrence[x]",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    },
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.occurrence[x]"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.done[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-3"
                    },
                    {
                        "identity": "rim",
                        "map": ".effectiveTime"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
                    }
                ]
            },
            {
                "id": "Immunization.recorded",
                "path": "Immunization.recorded",
                "short": "When the immunization was first captured in the subject's record",
                "definition": "The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.recorded",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.recorded"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=AUT].time"
                    }
                ]
            },
            {
                "id": "Immunization.primarySource",
                "path": "Immunization.primarySource",
                "short": "Indicates context the data was recorded in",
                "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.",
                "comment": "Reflects the “reliability” of the content.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.primarySource",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.source"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-9"
                    },
                    {
                        "identity": "rim",
                        "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.reportOrigin",
                "short": "Indicates the source of a secondarily reported record",
                "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.",
                "comment": "Should not be populated if primarySource = True, not required even if primarySource = False.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.reportOrigin",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationReportOrigin"
                        }
                    ],
                    "strength": "example",
                    "description": "The source of the data for a record which is not from a primary source.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-origin"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.source"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-9"
                    },
                    {
                        "identity": "rim",
                        "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)"
                    }
                ]
            },
            {
                "id": "Immunization.location",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.location",
                "short": "Where immunization occurred",
                "definition": "The service delivery location where the vaccine administration occurred.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.location",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Location"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.location"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.where[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=LOC].COCT_MT240000UV"
                    }
                ]
            },
            {
                "id": "Immunization.manufacturer",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.manufacturer",
                "short": "Vaccine manufacturer",
                "definition": "Name of vaccine manufacturer.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.manufacturer",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-17"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name"
                    }
                ]
            },
            {
                "id": "Immunization.lotNumber",
                "path": "Immunization.lotNumber",
                "short": "Vaccine lot number",
                "definition": "Lot number of the  vaccine product.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.lotNumber",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-15"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText"
                    }
                ]
            },
            {
                "id": "Immunization.expirationDate",
                "path": "Immunization.expirationDate",
                "short": "Vaccine expiration date",
                "definition": "Date vaccine batch expires.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.expirationDate",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "date"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-16"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
                    }
                ]
            },
            {
                "id": "Immunization.site",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.site",
                "short": "Body site vaccine  was administered",
                "definition": "Body site where vaccine was administered.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.site",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationSite"
                        }
                    ],
                    "strength": "preferred",
                    "description": "The site at which the vaccine was administered.",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationAdministrationBodySite"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "RXR-2"
                    },
                    {
                        "identity": "rim",
                        "map": "observation.targetSiteCode"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code"
                    }
                ]
            },
            {
                "id": "Immunization.route",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.route",
                "short": "How vaccine entered body",
                "definition": "The path by which the vaccine product is taken into the body.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.route",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationRoute"
                        }
                    ],
                    "strength": "preferred",
                    "description": "The route by which the vaccine was administered.",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "RXR-1"
                    },
                    {
                        "identity": "rim",
                        "map": ".routeCode"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code"
                    }
                ]
            },
            {
                "id": "Immunization.doseQuantity",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.doseQuantity",
                "short": "Amount of vaccine administered",
                "definition": "The quantity of vaccine product that was administered.",
                "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.doseQuantity",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "qty-3",
                        "severity": "error",
                        "human": "If a code for the unit is present, the system SHALL also be present",
                        "expression": "code.empty() or system.exists()",
                        "xpath": "not(exists(f:code)) or exists(f:system)",
                        "source": "http://hl7.org/fhir/StructureDefinition/Quantity"
                    },
                    {
                        "key": "sqty-1",
                        "severity": "error",
                        "human": "The comparator is not used on a SimpleQuantity",
                        "expression": "comparator.empty()",
                        "xpath": "not(exists(f:comparator))",
                        "source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "SN (see also Range) or CQ"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ, IVL<PQ>, MO, CO, depending on the values"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-6 / RXA-7"
                    },
                    {
                        "identity": "rim",
                        "map": ".doseQuantity"
                    }
                ]
            },
            {
                "id": "Immunization.performer",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.performer",
                "short": "Who performed event",
                "definition": "Indicates who performed the immunization event.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.performer",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.performer"
                    },
                    {
                        "identity": "v2",
                        "map": "ORC-12 / RXA-10"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
                    }
                ]
            },
            {
                "id": "Immunization.performer.id",
                "path": "Immunization.performer.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.performer.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.performer.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.performer.modifierExtension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.performer.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "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).",
                "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.performer.function",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.performer.function",
                "short": "What type of performance was done",
                "definition": "Describes the type of performance (e.g. ordering provider, administering provider, etc.).",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.performer.function",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationFunction"
                        }
                    ],
                    "strength": "extensible",
                    "description": "The role a practitioner or organization plays in the immunization event.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-function"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.performer.function"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation.functionCode"
                    }
                ]
            },
            {
                "id": "Immunization.performer.actor",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.performer.actor",
                "short": "Individual or organization who was performing",
                "definition": "The practitioner or organization who performed the action.",
                "comment": "When the individual practitioner who performed the action is known, it is best to send.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.performer.actor",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.performer.actor"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.actor"
                    },
                    {
                        "identity": "rim",
                        "map": ".player"
                    }
                ]
            },
            {
                "id": "Immunization.note",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.note",
                "short": "Additional immunization notes",
                "definition": "Extra information about the immunization that is not conveyed by the other attributes.",
                "comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.note",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Annotation"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.note"
                    },
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 48767-8"
                    },
                    {
                        "identity": "rim",
                        "map": "note"
                    }
                ]
            },
            {
                "id": "Immunization.reasonCode",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.reasonCode",
                "short": "Why immunization occurred",
                "definition": "Reasons why the vaccine was administered.",
                "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.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.reasonCode",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationReason"
                        }
                    ],
                    "strength": "preferred",
                    "description": "The reason why a vaccine was administered.",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationExplanationReason"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.reasonCode"
                    },
                    {
                        "identity": "rim",
                        "map": "[actionNegationInd=false].reasonCode"
                    }
                ]
            },
            {
                "id": "Immunization.reasonReference",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.reasonReference",
                "short": "Why immunization occurred",
                "definition": "Condition, Observation or DiagnosticReport that supports why the immunization was administered.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.reasonReference",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Condition",
                            "http://hl7.org/fhir/StructureDefinition/Observation",
                            "http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.reasonReference"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.isSubpotent",
                "path": "Immunization.isSubpotent",
                "short": "Dose potency",
                "definition": "Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.isSubpotent",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "meaningWhenMissing": "By default, a dose should be considered to be potent.",
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "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,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-20 = PA (partial administration)"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.subpotentReason",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.subpotentReason",
                "short": "Reason for being subpotent",
                "definition": "Reason why a dose is considered to be subpotent.",
                "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.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.subpotentReason",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "SubpotentReason"
                        }
                    ],
                    "strength": "example",
                    "description": "The reason why a dose is considered to be subpotent.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-subpotent-reason"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.education",
                "short": "Educational material presented to patient",
                "definition": "Educational material presented to the patient (or guardian) at the time of vaccine administration.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.education",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "imm-1",
                        "severity": "error",
                        "human": "One of documentType or reference SHALL be present",
                        "expression": "documentType.exists() or reference.exists()",
                        "xpath": "exists(f:documentType) or exists(f:reference)",
                        "source": "http://hl7.org/fhir/StructureDefinition/Immunization"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.id",
                "path": "Immunization.education.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.education.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.education.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.modifierExtension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.education.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "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).",
                "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.documentType",
                "path": "Immunization.education.documentType",
                "short": "Educational material document identifier",
                "definition": "Identifier of the material presented to the patient.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.education.documentType",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 69764-9"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.reference",
                "path": "Immunization.education.reference",
                "short": "Educational material reference pointer",
                "definition": "Reference pointer to the educational material given to the patient if the information was on line.",
                "comment": "see http://en.wikipedia.org/wiki/Uniform_resource_identifier",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.education.reference",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.publicationDate",
                "path": "Immunization.education.publicationDate",
                "short": "Educational material publication date",
                "definition": "Date the educational material was published.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.education.publicationDate",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 29768-9"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.presentationDate",
                "path": "Immunization.education.presentationDate",
                "short": "Educational material presentation date",
                "definition": "Date the educational material was given to the patient.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.education.presentationDate",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 29769-7"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.programEligibility",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.programEligibility",
                "short": "Patient eligibility for a vaccination program",
                "definition": "Indicates a patient's eligibility for a funding program.",
                "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.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.programEligibility",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ProgramEligibility"
                        }
                    ],
                    "strength": "example",
                    "description": "The patient's eligibility for a vaccation program.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-program-eligibility"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 64994-7"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.fundingSource",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.fundingSource",
                "short": "Funding source for the vaccine",
                "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).",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.fundingSource",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "FundingSource"
                        }
                    ],
                    "strength": "example",
                    "description": "The source of funding used to purchase the vaccine administered.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-funding-source"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.reaction",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.reaction",
                "short": "Details of a reaction that follows immunization",
                "definition": "Categorical data indicating that an adverse event is associated in time to an immunization.",
                "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.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.reaction",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "OBX-3"
                    },
                    {
                        "identity": "rim",
                        "map": "Observation[classCode=obs].code"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.id",
                "path": "Immunization.reaction.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.reaction.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.modifierExtension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.reaction.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "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).",
                "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.date",
                "path": "Immunization.reaction.date",
                "short": "When reaction started",
                "definition": "Date of reaction to the immunization.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.reaction.date",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "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": "rim",
                        "map": ".effectiveTime"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.detail",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.reaction.detail",
                "short": "Additional information on reaction",
                "definition": "Details of the reaction.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.reaction.detail",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Observation"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "v2",
                        "map": "OBX-5"
                    },
                    {
                        "identity": "rim",
                        "map": ".value"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.reported",
                "path": "Immunization.reaction.reported",
                "short": "Indicates self-reported reaction",
                "definition": "Self-reported indicator.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.reaction.reported",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(HL7 v2 doesn't seem to provide for this)"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.protocolApplied",
                "short": "Protocol followed by the provider",
                "definition": "The protocol (set of recommendations) being followed by the provider who administered the dose.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.protocolApplied",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.id",
                "path": "Immunization.protocolApplied.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.protocolApplied.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.modifierExtension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.protocolApplied.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "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).",
                "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.series",
                "path": "Immunization.protocolApplied.series",
                "short": "Name of vaccine series",
                "definition": "One possible path to achieve presumed immunity against a disease - within the context of an authority.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.protocolApplied.series",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.authority",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.protocolApplied.authority",
                "short": "Who is responsible for publishing the recommendations",
                "definition": "Indicates the authority who published the protocol (e.g. ACIP) that is being followed.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.protocolApplied.authority",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.targetDisease",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.protocolApplied.targetDisease",
                "short": "Vaccine preventatable disease being targetted",
                "definition": "The vaccine preventable disease the dose is being administered against.",
                "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.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.protocolApplied.targetDisease",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "TargetDisease"
                        }
                    ],
                    "strength": "example",
                    "description": "The vaccine preventable disease the dose is being administered for.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-target-disease"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.doseNumber[x]",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.protocolApplied.doseNumber[x]",
                "short": "Dose number within series",
                "definition": "Nominal position in a series.",
                "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).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.protocolApplied.doseNumber[x]",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "positiveInt"
                    },
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.seriesDoses[x]",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.protocolApplied.seriesDoses[x]",
                "short": "Recommended number of doses for immunity",
                "definition": "The recommended number of doses to achieve immunity.",
                "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).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.protocolApplied.seriesDoses[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "positiveInt"
                    },
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            }
        ]
    },
    "differential": {
        "element":  [
            {
                "id": "Immunization",
                "path": "Immunization",
                "constraint":  [
                    {
                        "key": "ukcore-imm-001",
                        "severity": "error",
                        "human": "If the immunization was not given then Immunization.status value SHALL = 'not-done', and the Immunization.statusReason SHALL be populated",
                        "expression": "(status != 'not-done') or (status = 'not-done' and statusReason.exists())"
                    }
                ]
            },
            {
                "id": "Immunization.extension:parentPresent",
                "path": "Immunization.extension",
                "sliceName": "parentPresent",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ParentPresent"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.extension:vaccinationProcedure",
                "path": "Immunization.extension",
                "sliceName": "vaccinationProcedure",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-VaccinationProcedure"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.status",
                "path": "Immunization.status",
                "mustSupport": true
            },
            {
                "id": "Immunization.statusReason",
                "path": "Immunization.statusReason",
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ReasonImmunizationNotAdministered"
                }
            },
            {
                "id": "Immunization.vaccineCode",
                "path": "Immunization.vaccineCode",
                "mustSupport": true,
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-VaccineCode"
                }
            },
            {
                "id": "Immunization.patient",
                "path": "Immunization.patient",
                "mustSupport": true
            },
            {
                "id": "Immunization.occurrence[x]",
                "path": "Immunization.occurrence[x]",
                "mustSupport": true
            },
            {
                "id": "Immunization.manufacturer",
                "path": "Immunization.manufacturer",
                "mustSupport": true
            },
            {
                "id": "Immunization.lotNumber",
                "path": "Immunization.lotNumber",
                "mustSupport": true
            },
            {
                "id": "Immunization.site",
                "path": "Immunization.site",
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationAdministrationBodySite"
                }
            },
            {
                "id": "Immunization.route",
                "path": "Immunization.route",
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute"
                }
            },
            {
                "id": "Immunization.doseQuantity",
                "path": "Immunization.doseQuantity",
                "mustSupport": true
            },
            {
                "id": "Immunization.reasonCode",
                "path": "Immunization.reasonCode",
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationExplanationReason"
                }
            }
        ]
    }
}

Examples

Influenza virus vaccine - An example to illustrate an Influenza virus vaccine.
Example UKCore-Immunization

Extension - ParentPresent - An example to illustrate the ParentPresent extension.
Example UKCore-Immunization-Extension-ParentPresent

Extension - VaccinationProcedure - An example to illustrate the VaccinationProcedure extension, with a vaccination procedure for an administered Influenza virus vaccine.
Example UKCore-Immunization-Extension-VaccinationProcedure

Extension - VaccinationProcedureCovid - An example to illustrate the VaccinationProcedureCovid extension, with a vaccination procedure for the COVID-19 Vaccine Vaxzevria.
Example UKCore-Immunization-Extension-VaccinationProcedureCovid

Example Usage Scenarios

The following are example usage scenarios for the UK Core Immunization profile:

  • Query and retrieve an individual’s immunisations (vaccinations)
  • Record or update an individual’s immunisations (vaccinations).

Profile Specific Implementation Guidance:

Mandatory and Must Support Data Elements

The following elements are identified as MustSupport, and it is expected that consumers and suppliers SHALL support these as per the MustSupport Guidance.

Element Reason
Immunization.status Indicates the current status of the immunization event.
Immunization.vaccineCode Vaccine that was administered or was to be administered.
Immunization.patient The patient who either received or did not receive the immunization.
Immunization.occurrence[x] When the vaccine administered or was to be administered.
Immunization.manufacturer Name of vaccine manufacturer.
Immunization.lotNumber Lot number of the vaccine.
Immunization.doseQuantity How much of the vaccine was administered

Extensions

More information about the extensions can be found using the links below.

Extension Context Link Comment
parentPresent Immunization Extension UKCore-ParentPresent Indicates if a parent was present at an immunisation.
vaccinationProcedure Immunization Extension UKCore-VaccinationProcedure to hold an immunisation procedure code.

This extension SHOULD be used when Immunization.status=completed.

This relates to the vaccine that was administered (procedure) and SHOULD be a SNOMED CT from ValueSet UKCore-VaccinationProcedure


Bindings (differential)

More information about the bindings to UK Core ValueSets can be found below.

Context Strength Link
Immunization.extension:vaccinationProcedure Preferred ValueSet UKCore-VaccinationProcedure
Immunization.reasonCode Preferred ValueSet UKCore-ImmunizationExplanationReason
Immunization.route Preferred ValueSet UKCore-SubstanceOrProductAdministrationRoute
Immunization.site Preferred ValueSet UKCore-ImmunizationAdministrationBodySite
Immunization.statusReason Preferred ValueSet UKCore-ReasonImmunizationNotAdministered
Immunization.vaccineCode Preferred ValueSet UKCore-VaccineCode

Constraints (differential)

More information about the constraints on the UKCore-Immunization profile can be found below.

Key Severity Expression Human Description
ukcore-imm-001 error (status != 'not-done') or
(status = 'not-done' and statusReason.exists())
If the immunization was not given then
Immunization.status value SHALL = 'not-done',
and the Immunization.statusReason SHALL be populated

status

Indicates the current status of the immunisation event.

For a vaccination that has been administered, the status will be completed. This status does not indicate a vaccination course has been completed. When the vaccination has not been administered, the status will be not-done and a Immunization.statusReason SHALL be populated.


vaccineCode

Vaccine that was administered or was to be administered.

This indicates vaccine product administered. This SHOULD be a dm+d code from ValueSet UKCore-VaccineCode. AMPP codes SHOULD NOT be used.

Example of Immunization.vaccineCode usage:

Table View

Immunization.id[0]UKCore-Immunization-Sn-AstraZenecaVaccine-Example
Immunization.status[0]completed
Immunization.vaccineCode[0].coding[0].system[0]https://dmd.nhs.uk
Immunization.vaccineCode[0].coding[0].code[0]39114911000001105
Immunization.vaccineCode[0].coding[0].display[0]COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)
Immunization.patient[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Immunization.occurrence[0]2021-07-20

Tree View

Immunization

XML View

<Immunization xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization-Sn-AstraZenecaVaccine-Example" />
    <status value="completed" />
    <!--  **************snippet start**************  -->
    <vaccineCode>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)" />
        </coding>
    </vaccineCode>
    <!--  **************snippet end**************  -->
    <patient>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </patient>
    <occurrenceDateTime value="2021-07-20" />
</Immunization>

JSON View

{
    "resourceType": "Immunization",
    "id": "UKCore-Immunization-Sn-AstraZenecaVaccine-Example",
    "status": "completed",
    "vaccineCode": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "occurrenceDateTime": "2021-07-20"
}

patient

A reference to the patient who either received or did not receive the immunisation. The resource being referenced SHOULD conform to Profile UKCore-Patient.

Example of Immunization.patient usage:

Table View

Immunization.id[0]UKCore-Immunization-Sn-PatientConformVaccination-Example
Immunization.status[0]completed
Immunization.vaccineCode[0].coding[0].system[0]https://dmd.nhs.uk
Immunization.vaccineCode[0].coding[0].code[0]39114911000001105
Immunization.vaccineCode[0].coding[0].display[0]COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)
Immunization.patient[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Immunization.patient[0].type[0]Patient
Immunization.patient[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
Immunization.patient[0].identifier[0].value[0]9912003888
Immunization.occurrence[0]2021-07-20

Tree View

Immunization

XML View

<Immunization xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization-Sn-PatientConformVaccination-Example" />
    <status value="completed" />
    <vaccineCode>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)" />
        </coding>
    </vaccineCode>
    <!--   **************snippet start**************   -->
    <patient>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
        <type value="Patient" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9912003888" />
        </identifier>
    </patient>
    <!--   **************snippet end**************   -->
    <occurrenceDateTime value="2021-07-20" />
</Immunization>

JSON View

{
    "resourceType": "Immunization",
    "id": "UKCore-Immunization-Sn-PatientConformVaccination-Example",
    "status": "completed",
    "vaccineCode": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example",
        "type": "Patient",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9912003888"
        }
    },
    "occurrenceDateTime": "2021-07-20"
}

encounter

The resource being referenced SHOULD conform to Profile UKCore-Encounter.


primarySource

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.

Set as true when the content of the record is based on information from the person performing the vaccine or who has clinical responsibility for the vaccination, and the system can be considered a primary source of the vaccination event. Set as false when the information has not come directly from people performing the vaccine (e.g. a patient or patient’s carer), and the system should not be treated as a primary source for this record. This is used to help identify and eliminate duplicate records held centrally.


location

The service delivery location where the vaccine administration occurred by reference to the location.

The resource being referenced SHOULD conform to Profile UKCore-Location.


manufacturer

Name of vaccine manufacturer by reference to the organisation. The resource being referenced SHOULD conform to Profile UKCore-Organization.

Example of Immunization.manufacturer usage:

Table View

Immunization.id[0]UKCore-Immunization-Sn-Manufacturer-Example
Immunization.status[0]completed
Immunization.vaccineCode[0].coding[0].system[0]https://dmd.nhs.uk
Immunization.vaccineCode[0].coding[0].code[0]39114911000001105
Immunization.vaccineCode[0].coding[0].display[0]COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)
Immunization.patient[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Immunization.occurrence[0]2021-07-20
Immunization.manufacturer[0].display[0]DREAMLAND Pharmaceuticals Ltd

Tree View

Immunization

XML View

<Immunization xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization-Sn-Manufacturer-Example" />
    <status value="completed" />
    <vaccineCode>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)" />
        </coding>
    </vaccineCode>
    <patient>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </patient>
    <occurrenceDateTime value="2021-07-20" />
    <!--  **************snippet start**************  -->
    <manufacturer>
        <display value="DREAMLAND Pharmaceuticals Ltd" />
    </manufacturer>
    <!--  **************snippet end**************  -->
</Immunization>

JSON View

{
    "resourceType": "Immunization",
    "id": "UKCore-Immunization-Sn-Manufacturer-Example",
    "status": "completed",
    "vaccineCode": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "occurrenceDateTime": "2021-07-20",
    "manufacturer": {
        "display": "DREAMLAND Pharmaceuticals Ltd"
    }
}

lotNumber

Lot number of the vaccine product.

Where Immunization.status=completed this SHOULD be present.

This should be captured at source ideally via use of automated scanning technology (GS1 GTIN / NTIN standard).

Example of Immunization.lotNumber usage:

Table View

Immunization.id[0]UKCore-Immunization-Sn-LotNumber-Example
Immunization.status[0]completed
Immunization.vaccineCode[0].coding[0].system[0]https://dmd.nhs.uk
Immunization.vaccineCode[0].coding[0].code[0]39114911000001105
Immunization.vaccineCode[0].coding[0].display[0]COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)
Immunization.patient[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Immunization.occurrence[0]2021-07-20
Immunization.lotNumber[0]R04X

Tree View

Immunization

XML View

<Immunization xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization-Sn-LotNumber-Example" />
    <status value="completed" />
    <vaccineCode>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)" />
        </coding>
    </vaccineCode>
    <patient>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </patient>
    <occurrenceDateTime value="2021-07-20" />
    <!--  **************snippet start**************  -->
    <lotNumber value="R04X" />
    <!--  **************snippet end**************  -->
</Immunization>

JSON View

{
    "resourceType": "Immunization",
    "id": "UKCore-Immunization-Sn-LotNumber-Example",
    "status": "completed",
    "vaccineCode": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "occurrenceDateTime": "2021-07-20",
    "lotNumber": "R04X"
}

site

Body site where vaccine was administered.

A SNOMED CT Concept ID value from UK published reference set “Vaccine body site of administration simple reference set” (1127941000000100) SHOULD be used ValueSet UKCore-ImmunizationAdministrationBodySite.

Example of Immunization.site usage:

Table View

Immunization.id[0]UKCore-Immunization-Sn-LeftUpperArmStructure-Example
Immunization.status[0]completed
Immunization.vaccineCode[0].coding[0].system[0]https://dmd.nhs.uk
Immunization.vaccineCode[0].coding[0].code[0]39114911000001105
Immunization.vaccineCode[0].coding[0].display[0]COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)
Immunization.patient[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Immunization.occurrence[0]2021-07-20
Immunization.site[0].coding[0].system[0]http://snomed.info/sct
Immunization.site[0].coding[0].code[0]368208006
Immunization.site[0].coding[0].display[0]Left upper arm structure (body structure)

Tree View

Immunization

XML View

<Immunization xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization-Sn-LeftUpperArmStructure-Example" />
    <status value="completed" />
    <vaccineCode>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)" />
        </coding>
    </vaccineCode>
    <patient>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </patient>
    <occurrenceDateTime value="2021-07-20" />
    <!--  **************snippet start**************  -->
    <site>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="368208006" />
            <display value="Left upper arm structure (body structure)" />
        </coding>
    </site>
    <!--  **************snippet end**************  -->
</Immunization>

JSON View

{
    "resourceType": "Immunization",
    "id": "UKCore-Immunization-Sn-LeftUpperArmStructure-Example",
    "status": "completed",
    "vaccineCode": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "occurrenceDateTime": "2021-07-20",
    "site": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "368208006",
                "display": "Left upper arm structure (body structure)"
            }
        ]
    }
}

route

The path by which the vaccine product is taken into the body.

A SNOMED CT concept ID value from either of the following SHOULD be used:
UK “ePrescribing route of administration simple reference set (foundation metadata concept)” (999000051000001100) ValueSet UKCore-SubstanceOrProductAdministrationRoute
or:
UK published reference set “Vaccine route of administration simple reference set” (115231000001104).

Example of Immunization.route usage:

Table View

Immunization.id[0]UKCore-Immunization-Sn-IntramuscularRoute-Example
Immunization.status[0]completed
Immunization.vaccineCode[0].coding[0].system[0]https://dmd.nhs.uk
Immunization.vaccineCode[0].coding[0].code[0]39114911000001105
Immunization.vaccineCode[0].coding[0].display[0]COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)
Immunization.patient[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Immunization.occurrence[0]2021-07-20
Immunization.route[0].coding[0].system[0]http://snomed.info/sct
Immunization.route[0].coding[0].code[0]78421000
Immunization.route[0].coding[0].display[0]Intramuscular route (qualifier value)

Tree View

Immunization

XML View

<Immunization xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization-Sn-IntramuscularRoute-Example" />
    <status value="completed" />
    <vaccineCode>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)" />
        </coding>
    </vaccineCode>
    <patient>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </patient>
    <occurrenceDateTime value="2021-07-20" />
    <!--  **************snippet start**************  -->
    <route>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="78421000" />
            <display value="Intramuscular route (qualifier value)" />
        </coding>
    </route>
    <!--  **************snippet end**************  -->
</Immunization>

JSON View

{
    "resourceType": "Immunization",
    "id": "UKCore-Immunization-Sn-IntramuscularRoute-Example",
    "status": "completed",
    "vaccineCode": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "occurrenceDateTime": "2021-07-20",
    "route": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "78421000",
                "display": "Intramuscular route (qualifier value)"
            }
        ]
    }
}

doseQuantity

The quantity of vaccine product that was administered.

By preference, use UCUM units of measure. Examples of when a UCUM unit of measure would be used are “gram” or “milliliter” or “percent”.

Where a UCUM unit of measure is not defined, use a SNOMED CT unit of measure. Examples of when a SNOMED CT unit of measure would typically be used are “tablet”, “capsule” or “ampule”.

Example of Immunization.doseQuantity usage:

Table View

Immunization.id[0]UKCore-Immunization-Sn-UnitsOfMeasure-Example
Immunization.status[0]completed
Immunization.vaccineCode[0].coding[0].system[0]https://dmd.nhs.uk
Immunization.vaccineCode[0].coding[0].code[0]39114911000001105
Immunization.vaccineCode[0].coding[0].display[0]COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)
Immunization.patient[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Immunization.occurrence[0]2021-07-20
Immunization.doseQuantity[0].value[0]0.5
Immunization.doseQuantity[0].unit[0]milliliter
Immunization.doseQuantity[0].system[0]http://unitsofmeasure.org
Immunization.doseQuantity[0].code[0]ml

Tree View

Immunization

XML View

<Immunization xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization-Sn-UnitsOfMeasure-Example" />
    <status value="completed" />
    <vaccineCode>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)" />
        </coding>
    </vaccineCode>
    <patient>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </patient>
    <occurrenceDateTime value="2021-07-20" />
    <!--  **************snippet start**************  -->
    <doseQuantity>
        <value value="0.5" />
        <unit value="milliliter" />
        <system value="http://unitsofmeasure.org" />
        <code value="ml" />
    </doseQuantity>
    <!--  **************snippet end**************  -->
</Immunization>

JSON View

{
    "resourceType": "Immunization",
    "id": "UKCore-Immunization-Sn-UnitsOfMeasure-Example",
    "status": "completed",
    "vaccineCode": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "occurrenceDateTime": "2021-07-20",
    "doseQuantity": {
        "value": 0.5,
        "unit": "milliliter",
        "system": "http://unitsofmeasure.org",
        "code": "ml"
    }
}

performer

Indicates who performed the immunisation event by reference. The resource being referenced SHOULD conform to one of the following:

Example of Immunization.performer usage:

Table View

Immunization.id[0]UKCore-Immunization-Sn-Performer-Example
Immunization.status[0]completed
Immunization.vaccineCode[0].coding[0].system[0]https://dmd.nhs.uk
Immunization.vaccineCode[0].coding[0].code[0]39114911000001105
Immunization.vaccineCode[0].coding[0].display[0]COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)
Immunization.patient[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Immunization.occurrence[0]2021-07-20
Immunization.performer[0].actor[0].type[0]Practitioner
Immunization.performer[0].actor[0].identifier[0].system[0]https://fhir.hl7.org.uk/Id/nmc-number
Immunization.performer[0].actor[0].identifier[0].value[0]5566789
Immunization.performer[0].actor[0].display[0]HOLDING, Rafferty
Immunization.performer[1].actor[0].type[0]Organization
Immunization.performer[1].actor[0].identifier[0].system[0]https://fhir.nhs.uk/Id/ods-organization-code
Immunization.performer[1].actor[0].identifier[0].value[0]C4B2A
Immunization.performer[1].actor[0].display[0]ELLAND ROAD STADIUM - COVID VACCINATION CENTRE

Tree View

Immunization

XML View

<Immunization xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization-Sn-Performer-Example" />
    <status value="completed" />
    <vaccineCode>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)" />
        </coding>
    </vaccineCode>
    <patient>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </patient>
    <occurrenceDateTime value="2021-07-20" />
    <!--  **************snippet start**************  -->
    <performer>
        <actor>
            <type value="Practitioner" />
            <identifier>
                <system value="https://fhir.hl7.org.uk/Id/nmc-number" />
                <value value="5566789" />
            </identifier>
            <display value="HOLDING, Rafferty" />
        </actor>
    </performer>
    <performer>
        <actor>
            <type value="Organization" />
            <identifier>
                <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                <value value="C4B2A" />
            </identifier>
            <display value="ELLAND ROAD STADIUM - COVID VACCINATION CENTRE" />
        </actor>
    </performer>
    <!--  **************snippet end**************  -->
</Immunization>

JSON View

{
    "resourceType": "Immunization",
    "id": "UKCore-Immunization-Sn-Performer-Example",
    "status": "completed",
    "vaccineCode": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "occurrenceDateTime": "2021-07-20",
    "performer":  [
        {
            "actor": {
                "type": "Practitioner",
                "identifier": {
                    "system": "https://fhir.hl7.org.uk/Id/nmc-number",
                    "value": "5566789"
                },
                "display": "HOLDING, Rafferty"
            }
        },
        {
            "actor": {
                "type": "Organization",
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                    "value": "C4B2A"
                },
                "display": "ELLAND ROAD STADIUM - COVID VACCINATION CENTRE"
            }
        }
    ]
}

reasonReference

Why immunisation occurred by reference to Condition, Observation or DiagnosticReport.

The resource being referenced SHOULD conform to one of the following:


protocolApplied

The protocol (set of recommendations) being followed by the provider who administered the dose.

protocolApplied.targetDisease

It is recommended for international/EU interoperability that Immunization.protocolApplied.targetDisease is populated. The SNOMED CT concept SHOULD be from EU COVID-19 Diseases or Vaccine Target Diseases (GPS) - IPS

Disease UK SNOMED self
COVID-19 840539006
Others See "Vaccine Target Diseases (GPS) - IPS"

protocolApplied.doseNumberPositiveInt

Nominal position in a series of vaccines, N.B. This field will not always be reliable, therefore for Covid vaccinations, the vaccination procedure code or situation code SHOULD be used as that includes the dose number.

Example of Immunization.protocolApplied usage:

Table View

Immunization.id[0]UKCore-Immunization-Sn-ProtocolApplied-Example
Immunization.status[0]completed
Immunization.vaccineCode[0].coding[0].system[0]https://dmd.nhs.uk
Immunization.vaccineCode[0].coding[0].code[0]39114911000001105
Immunization.vaccineCode[0].coding[0].display[0]COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)
Immunization.patient[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Immunization.occurrence[0]2021-07-20
Immunization.protocolApplied[0].targetDisease[0].coding[0].system[0]http://snomed.info/sct
Immunization.protocolApplied[0].targetDisease[0].coding[0].code[0]840539006
Immunization.protocolApplied[0].targetDisease[0].coding[0].display[0]COVID-19
Immunization.protocolApplied[0].doseNumber[0]1

Tree View

Immunization

XML View

<Immunization xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization-Sn-ProtocolApplied-Example" />
    <status value="completed" />
    <vaccineCode>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)" />
        </coding>
    </vaccineCode>
    <patient>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </patient>
    <occurrenceDateTime value="2021-07-20" />
    <!--  **************snippet start**************  -->
    <protocolApplied>
        <targetDisease>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="840539006" />
                <display value="COVID-19" />
            </coding>
        </targetDisease>
        <doseNumberPositiveInt value="1" />
    </protocolApplied>
    <!--  **************snippet end**************  -->
</Immunization>

JSON View

{
    "resourceType": "Immunization",
    "id": "UKCore-Immunization-Sn-ProtocolApplied-Example",
    "status": "completed",
    "vaccineCode": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine Vaxzevria (ChAdOx1 S [recombinant]) not less than 2.5x100,000,000 infectious units/0.5ml dose suspension for injection multidose vials (AstraZeneca UK Ltd)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "occurrenceDateTime": "2021-07-20",
    "protocolApplied":  [
        {
            "targetDisease":  [
                {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "840539006",
                            "display": "COVID-19"
                        }
                    ]
                }
            ],
            "doseNumberPositiveInt": 1
        }
    ]
}

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