Path | Short | Definition | Comments |
---|---|---|---|
Immunization evaluation information | Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations. | ||
identifier | Business identifier | A unique identifier assigned to this immunization evaluation record. | |
status | completed | entered-in-error | Indicates the current status of the evaluation of the vaccination administration event. | |
patient | Who this evaluation is for | The individual for whom the evaluation is being done. | |
date | Date evaluation was performed | The date the evaluation of the vaccine administration event was performed. | |
authority | Who is responsible for publishing the recommendations | Indicates the authority who published the protocol (e.g. ACIP). | |
targetDisease | Evaluation target disease | The vaccine preventable disease the dose is being evaluated against. | |
immunizationEvent | Immunization being evaluated | The vaccine administration event being evaluated. | |
doseStatus | Status of the dose relative to published recommendations | Indicates if the dose is valid or not valid with respect to the published recommendations. | |
doseStatusReason | Reason for the dose status | Provides an explanation as to why the vaccine administration event is valid or not relative to the published recommendations. | |
description | Evaluation notes | Additional information about the evaluation. | |
series | Name of vaccine series | One possible path to achieve presumed immunity against a disease - within the context of an authority. | |
doseNumber[x] | Dose number within series | Nominal position in a series. | The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose). |
seriesDoses[x] | Recommended number of doses for immunity | The recommended number of doses to achieve immunity. | The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose). |
The ImmunizationEvaluation resource is intended to cover communicating the results of an evaluation of a vaccine administration event (documented using the Immunization resource) against a set of published recommendations (protocols). Evaluating administered doses in a patient's immunization history is central to ensuring that the patient if fully protected against vaccine-preventable diseases. It is also a necessary prerequisite to generating a customized set of immunization recommendations for the patient.
The ImmunizationEvaluation resource communicates the results of an evaluation of an instance of the Immunization resource relative to a set of published recommendations. It is intended to communicate if the vaccine administration event was "valid" or "not valid" relative to the recommendations. Once all vaccine administration events in a patient's record have been evaluated, it is then possible to generate a set of vaccination related recommendations, unique for the patient. These recommendations are communicated using the ImmunizationRecommedation resource.
As the ImmunizationEvaluation resource is focused on the evaluation of a single vaccine administration event, it does not include data regarding the overall patient status relative to the recommendations used in the evaluation. For example, a total of 3 doses of hepatitis B vaccine may be required for patient protection, but an instance of the ImmunizationEvaluation resource will be concerned with only one of the doses (although other instances of ImmunizationEvaluation should exist for the other doses). The ImmunizationRecommendation resource is used to convey the overall patient status (eg. a dose is due or the patient is complete) relative to the hepatitis B series.
Through FHIR Release 3, the Immunization resource contained a "protocol" backbone element which functioned as an evaluation of the vaccine administration event. Beginning in Release 4, this new resource replaces the Immunization.protocol element.
A single vaccine administration event (as communicated via the Immunization resource) may be evaluated against multiple published recommendations, against the same set of published recommendations at different points in time or against published recommendations for different vaccine-preventable diseases. That is a single Immunization record may be linked to multiple ImmunizationEvaluation records.
For example a dose of Twinrix contains antigen against both Hepatitis A and Hepatitis B. The evaluation of such a dose should happen against recommendations for both types of Hepatitis. Furthermore, the dose may be evaluated against both national and local recommendation or may be evaluated against either set of recommendations at multiple points in time (yearly as the patient comes in for standard "well person" appointment with their care provider).
Typically a single "recommendation" is prepared for the patient based on the evaluation of all of the vaccine administration events in the patient's history. This "recommendation" may include individual recommendations for multiple vaccines/vaccine groups. For example, a recommendation may be generated that includes recommendations for both influenza and diphtheria/tetanus vaccinations. Such recommendations use the ImmunizationRecommedation resource.
date | Date the evaluation was generated | ImmunizationEvaluation.date |
dose-status | The status of the dose relative to published recommendations | ImmunizationEvaluation.doseStatus |
identifier | ID of the evaluation | ImmunizationEvaluation.identifier |
immunization-event | The vaccine administration event being evaluated | ImmunizationEvaluation.immunizationEvent |
patient | The patient being evaluated | ImmunizationEvaluation.patient |
status | Immunization evaluation status | ImmunizationEvaluation.status |
target-disease | The vaccine preventable disease being evaluated against | ImmunizationEvaluation.targetDisease |