Immunization

• Overview
  • Errors
• Terminology Bindings
• Search
  • Authorization Types
  • Parameters
  • Headers
  • Example
  • Example with RevInclude
  • Authorization Types
• Retrieve by ID
  • Authorization Types
  • Headers
  • Example
• Create
  • Authorization Types
  • Headers
  • Body Fields
  • Example
• Update
  • Authorization Types
  • Headers
  • Body fields
  • Example

Overview

The Immunization resource is intended to cover the recording of current and historical administration of vaccines to patients across all healthcare disciplines, in all care settings, and all regions. This resource contains the functionality to query a patient’s immunization history. You can find detailed administration records in the MedicationAdministration resource, while this Immunization resource represents the known vaccination history regardless of where the administration itself was done.

An immunization reaction may indicate an allergy or intolerance. If so, create a separate AllergyIntolerance resource instance as well.

Note that while the terms immunization and vaccination are not clinically identical, for the purposes of FHIR resources, the terms are used synonymously.

• This resource supports the following HL7 FHIR US Core Implementation Guide STU 4.0.0 profiles:

  • US Core Immunization Profile

The following fields are returned if valued:

• ID
• Immunization Record Identifier
• Status
• Status reason
• Vaccine administered
• Patient
• Patient encounter
• Occurrence DateTime
• Primary Source
• Report Origin
• Location
• Vaccine manufacturer
• Vaccine lot number
• Vaccine expiration date
• Vaccine administration site
• Vaccine administration route
• Dosage administered
• Performer
  • Type of performer (ordering or administering)
  • Individual who performed
    • Reference (Practitioner | Organization)
• Note (follows Annotation structure)
  • Reference (Practitioner)
  • Time
  • Text
• Protocol applied
  • Dose Number String
  • Target disease

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Errors

The common errors and OperationOutcomes may be returned.

Terminology Bindings

Immunization.statusReason

Description Reason the immunization was not performed. Details: Immunization Status Reason System: http://terminology.hl7.org/CodeSystem/v3-ActReason Details: Millennium Expire Reasons System: https://fhir.cerner.com/<EHR source id>/codeSet/30440

Immunization.vaccineCode

Description Vaccine product administered. Note The CVX binding will always be returned. An NDC binding will be returned when available. Details: CVX System: http://hl7.org/fhir/sid/cvx Details: NDC System: http://hl7.org/fhir/sid/ndc Details: Millennium Clinical Event Code System: https://fhir.cerner.com/<EHR source id>/codeSet/72

Immunization.reportOrigin

Description The source of an immunization record when not reported by the person who administered the vaccine. Details: Immunization Report Origin System: http://terminology.hl7.org/CodeSystem/immunization-origin Details: Millennium Source from which a Result Originated System: https://fhir.cerner.com/<EHR source id>/codeSet/30200

Immunization.site

Description The site at which the vaccine was administered. Details: SNOMED CT System: http://snomed.info/sct Details: Millennium Medication Site System: https://fhir.cerner.com/<EHR source id>/codeSet/97

Immunization.route

Description The path by which the vaccine product was taken into the body. Details: SNOMED CT System: http://snomed.info/sct Details: Millennium Route System: https://fhir.cerner.com/<EHR source id>/codeSet/4001

Immunization.protocolApplied.targetDisease

Description The vaccine preventable disease the dose is being administered against. Details: CVX System: http://hl7.org/fhir/sid/cvx Details: SNOMED CT System: http://snomed.info/sct Details: Millennium Vaccine Group Code System: https://fhir.cerner.com/<EHR source id>/codeSet/4003106

Search

Search for immunizations that meet supplied query parameters:

GET /Immunization?:parameters

Authorization Types

Parameters

Name	Required?	Type	Description
_id	Conditionally	token	The logical resource ID associated with the resource. This parameter is required if the patient parameter is not used. Example: M12345
patient	Conditionally	reference	The patient for the vaccination record. This parameter is required if the _id parameter is not used. Example: 12345
date	No	date	The date range for the immunization administration or administrations. Example: date=ge2020-01-01T08:00:00.000Z&date=le2020-01-31T17:00:00.000Z
_lastUpdated	No	date	Date on which the immunization was last updated. Example: _lastUpdated=gt2014-09-24 or _lastUpdated=gt2014-09-24T12:00:00.000Z
target-disease	No	token	The target disease that the dose is being administered against. Example: http://hl7.org/fhir/sid/cvx|213
_revinclude	No	token	The Provenance resource entries that are returned as part of the bundle.

Implementation Notes

• When searching with the _id parameter:
  • It can be provided with either a single reference, or a comma-separated list of references. Example: _id=M1234 or _id=M1234,M5678
  • It must not be provided with any other parameters, except with _revinclude as indicated below.
• When searching with the patient parameter:
  • It can be provided with only a single reference; a comma-separated list is not supported.
• When searching with the date parameter:
  • For a single date occurrence:
    • It must be provided with either the le or ge prefix to search for vaccination record administrations earlier or later than the given date.
    • The time component is optional.
  • For two date occurrences:
    • It must be provided with le and ge prefixes to search for vaccination records within a specific range.
    • The time component is optional, but must be consistent. If one date has a time component, so must the other.
• When searching with _lastUpdated parameter:
  • It can be provided with only a single reference, and must use the gt or ge prefix
  • The time component is optional.
  • The date and _lastUpdated parameters may not be provided together.
• When searching with the target-disease parameter:
  • Searching by Cerner Millennium proprietary codes is not supported.
• When searching with the _revinclude parameter:
  • It can be provided once with the Provenance:target value. Example: _revinclude=Provenance:target
  • It can be provided with the _id or patient parameter. Example: _id=M17255835&_revinclude=Provenance:target
• When _revinclude is provided in a request to the closed endpoint, the OAuth2 token must include the scope corresponding to the Authorization Type, such as user/Provenance.read, patient/Provenance.read or system/Provenance.read.

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization?patient=12724066

Response

Status: 200 OK

{
  "resourceType": "Bundle",
  "id": "24685278-6535-4770-9705-974db80e729b",
  "type": "searchset",
  "total": 2,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization?patient=12724066"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/M197197986",
      "resource": {
        "resourceType": "Immunization",
        "id": "M197197986",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2019-12-26T13:12:59-06:00"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Immunization</b></p><p><b>Vaccine</b>: tetanus toxoid</p><p><b>Occurrence</b>: 1982</p><p><b>Patient</b>: SMART, NANCY</p><p><b>Status</b>: Completed</p></div>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2798767",
              "display": "tetanus toxoid",
              "userSelected": true
            },
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "112",
              "display": "tetanus toxoid, unspecified formulation",
              "userSelected": false
            }
          ],
          "text": "tetanus toxoid"
        },
        "patient": {
          "reference": "Patient/12724066",
          "display": "SMART, NANCY"
        },
        "encounter": {
          "reference": "Encounter/97939518"
        },
        "occurrenceDateTime": "1982",
        "primarySource": false,
        "reportOrigin": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200",
              "code": "679978",
              "display": "Self",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/immunization-origin",
              "code": "recall",
              "display": "Parent/Guardian/Patient Recall",
              "userSelected": false
            }
          ],
          "text": "Self"
        },
        "location": {
          "reference": "Location/32545019",
          "display": "A"
        },
        "doseQuantity": {
          "value": 0.0,
          "unit": "unknown unit",
          "system": "http://unitsofmeasure.org",
          "code": "{unknownunit}"
        },
        "protocolApplied": [
          {
            "targetDisease": [
              {
                "coding": [
                  {
                    "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/4003106",
                    "code": "2289043429",
                    "display": "COVID-19",
                    "userSelected": true
                  },
                  {
                    "system": "http://hl7.org/fhir/sid/cvx",
                    "code": "213",
                    "display": "SARS-COV-2 (COVID-19) vaccine, UNSPECIFIED",
                    "userSelected": false
                  }
                ],
                "text": "COVID-19"
              }
            ],
            "doseNumberString": "Unknown"
          }
        ]
      }
    },
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/M197197982",
      "resource": {
        "resourceType": "Immunization",
        "id": "M197197982",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2019-12-26T13:12:59-06:00"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Immunization</b></p><p><b>Vaccine</b>: influenza virus vaccine, live</p><p><b>Occurrence</b>: 2019</p><p><b>Patient</b>: SMART, NANCY</p><p><b>Status</b>: Completed</p></div>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2820756",
              "display": "influenza virus vaccine, live",
              "userSelected": true
            },
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "111",
              "display": "influenza, live, intranasal",
              "userSelected": false
            }
          ],
          "text": "influenza virus vaccine, live"
        },
        "patient": {
          "reference": "Patient/12724066",
          "display": "SMART, NANCY"
        },
        "encounter": {
          "reference": "Encounter/97939518"
        },
        "occurrenceDateTime": "2019",
        "primarySource": false,
        "reportOrigin": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200",
              "code": "679978",
              "display": "Self",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/immunization-origin",
              "code": "recall",
              "display": "Parent/Guardian/Patient Recall",
              "userSelected": false
            }
          ],
          "text": "Self"
        },
        "location": {
          "reference": "Location/32545019",
          "display": "A"
        },
        "doseQuantity": {
          "value": 0.0,
          "unit": "unknown unit",
          "system": "http://unitsofmeasure.org",
          "code": "{unknownunit}"
        }
      }
    }
  ]
}

Example with RevInclude

Authorization Types

Request

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization?_id=M17255835,M17255827&_revinclude=Provenance:target

Response

Status: 200 OK

{
  "resourceType": "Bundle",
  "id": "d186de6b-664c-4fe1-b311-5569c9a559cd",
  "type": "searchset",
  "total": 2,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-ehr-partners.devcernerpowerchart.com/r4/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/Immunization?_id=M17255835,M17255827&_revinclude=Provenance%3Atarget"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-ehr-partners.devcernerpowerchart.com/r4/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/Immunization/M17255835",
      "resource": {
        "resourceType": "Immunization",
        "id": "M17255835",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2020-04-07T22:19:45+00:00"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Immunization</b></p><p><b>Vaccine</b>: cholera vaccine</p><p><b>Occurrence</b>: Apr  5, 2020</p><p><b>Patient</b>: HEATHERJSMITH</p><p><b>Status</b>: Completed</p><p><b>Organization</b>: Baseline West Medical Center</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CEfda49233-ccfa-4ed4-afbc-9f5082c2bf0c-17255835-2020040717194500"
          }
        ],
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/72",
              "code": "4337240",
              "display": "cholera vaccine",
              "userSelected": true
            },
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "26",
              "display": "cholera vaccine, unspecified formulation",
              "userSelected": false
            }
          ],
          "text": "cholera vaccine"
        },
        "patient": {
          "reference": "Patient/744104",
          "display": "HEATHERJSMITH"
        },
        "encounter": {
          "reference": "Encounter/5330647"
        },
        "occurrenceDateTime": "2020-04-05",
        "primarySource": false,
        "reportOrigin": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/30200",
              "code": "19162979",
              "display": "Primary Care Provider",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/immunization-origin",
              "code": "provider",
              "display": "Other Provider",
              "userSelected": false
            }
          ],
          "text": "Primary Care Provider"
        },
        "location": {
          "reference": "Location/633867",
          "display": "Baseline West"
        },
        "doseQuantity": {
          "value": 0.0,
          "unit": "unknown unit",
          "system": "http://unitsofmeasure.org",
          "code": "{unknownunit}"
        },
        "performer": [
          {
            "actor": {
              "reference": "Organization/589723",
              "display": "Baseline West Medical Center"
            }
          }
        ]
      },
      "search": {
        "mode": "match"
      }
    },
    {
      "fullUrl": "https://fhir-ehr-partners.devcernerpowerchart.com/r4/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/Immunization/M17255827",
      "resource": {
        "resourceType": "Immunization",
        "id": "M17255827",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2020-04-07T22:17:33+00:00"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Immunization</b></p><p><b>Vaccine</b>: diphtheria/pertussis, acel/tetanus ped</p><p><b>Occurrence</b>: Apr  7, 2020</p><p><b>Patient</b>: HEATHERJSMITH</p><p><b>Status</b>: Not Done</p><p><b>Status Reason</b>: Patient Refuses</p><p><b>Organization</b>: Baseline West Medical Center</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CEfda49233-ccfa-4ed4-afbc-9f5082c2bf0c-17255827-2020040717173300"
          }
        ],
        "status": "not-done",
        "statusReason": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/30440",
              "code": "679607",
              "display": "Patient Refuses",
              "userSelected": true
            },
            {
              "system": "http://snomed.info/sct",
              "code": "591000119102",
              "display": "Vaccine refused by patient (situation)",
              "userSelected": false
            }
          ],
          "text": "Patient Refuses"
        },
        "vaccineCode": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/codeSet/72",
              "code": "4145944",
              "display": "diphtheria/pertussis, acel/tetanus ped",
              "userSelected": true
            },
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "20",
              "display": "diphtheria, tetanus toxoids and acellular pertussis vaccine",
              "userSelected": false
            }
          ],
          "text": "diphtheria/pertussis, acel/tetanus ped"
        },
        "patient": {
          "reference": "Patient/744104",
          "display": "HEATHERJSMITH"
        },
        "occurrenceDateTime": "2020-04-07",
        "primarySource": true,
        "performer": [
          {
            "actor": {
              "reference": "Organization/589723",
              "display": "Baseline West Medical Center"
            }
          }
        ]
      },
      "search": {
        "mode": "match"
      }
    },
    {
      "fullUrl": "https://fhir-ehr-partners.devcernerpowerchart.com/r4/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/Provenance/imm-12568185",
      "resource": {
        "resourceType": "Provenance",
        "id": "imm-12568185",
        "meta": {
          "versionId": "12568185",
          "lastUpdated": "2021-05-14T10:08:47-05:00"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Provenance</b></p><p><b>Target</b>:</p><ul><li>Immunization/M17255835</li></ul><p><b>Recorded</b>: Oct 25, 2019  9:57 A.M. CDT</p><p><b>Agents</b>:</p><dl><dt>Unknown</dt><dd><b>Agent Type</b>: Transmitter</dd><dd><b>Agent Role</b>: Source</dd></dl><p><b>Entity Source</b>: DocumentReference/17255835</p></div>"
        },
        "target": [
          {
            "reference": "Immunization/M17255835"
          }
        ],
        "recorded": "2019-10-25T09:57:43-05:00",
        "agent": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type",
                  "code": "transmitter"
                }
              ],
              "text": "Transmitter"
            },
            "role": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
                    "code": "SOURCE"
                  }
                ],
                "text": "Source"
              }
            ],
            "who": {
              "reference": "Organization/619848",
              "display": "Unknown"
            }
          }
        ],
        "entity": [
          {
            "role": "source",
            "what": {
              "reference": "DocumentReference/17255835"
            }
          }
        ]
      },
      "search": {
        "mode": "include"
      }
    },
    {
      "fullUrl": "https://fhir-ehr-partners.devcernerpowerchart.com/r4/eb2384f8-839e-4c6e-8b29-18e71db1a0b1/Provenance/imm-12595155",
      "resource": {
        "resourceType": "Provenance",
        "id": "imm-12595155",
        "meta": {
          "versionId": "12595155",
          "lastUpdated": "2021-05-17T01:08:34-05:00"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Provenance</b></p><p><b>Target</b>:</p><ul><li>Immunization/M17255835</li></ul><p><b>Recorded</b>: Oct 25, 2019  9:57 A.M. CDT</p><p><b>Agents</b>:</p><dl><dt>Unknown</dt><dd><b>Agent Type</b>: Transmitter</dd><dd><b>Agent Role</b>: Source</dd></dl><p><b>Entity Source</b>: DocumentReference/17255835</p></div>"
        },
        "target": [
          {
            "reference": "Immunization/M17255835"
          }
        ],
        "recorded": "2019-10-25T09:57:43-05:00",
        "agent": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type",
                  "code": "transmitter"
                }
              ],
              "text": "Transmitter"
            },
            "role": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
                    "code": "SOURCE"
                  }
                ],
                "text": "Source"
              }
            ],
            "who": {
              "reference": "Organization/619848",
              "display": "Unknown"
            }
          }
        ],
        "entity": [
          {
            "role": "source",
            "what": {
              "reference": "DocumentReference/17255835"
            }
          }
        ]
      },
      "search": {
        "mode": "include"
      }
    }
  ]
}

Patient Authorization Request

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization?patient=12724066

Response

Status: 200 OK

{
  "resourceType": "Bundle",
  "id": "24685278-6535-4770-9705-974db80e729b",
  "type": "searchset",
  "total": 2,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization?patient=12724066"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/M197197986",
      "resource": {
        "resourceType": "Immunization",
        "id": "M197197986",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2019-12-26T13:12:59-06:00"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Immunization</b></p><p><b>Vaccine</b>: tetanus toxoid</p><p><b>Occurrence</b>: 1982</p><p><b>Patient</b>: SMART, NANCY</p><p><b>Status</b>: Completed</p></div>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2798767",
              "display": "tetanus toxoid",
              "userSelected": true
            },
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "112",
              "display": "tetanus toxoid, unspecified formulation",
              "userSelected": false
            }
          ],
          "text": "tetanus toxoid"
        },
        "patient": {
          "reference": "Patient/12724066",
          "display": "SMART, NANCY"
        },
        "encounter": {
          "reference": "Encounter/97939518"
        },
        "occurrenceDateTime": "1982",
        "primarySource": false,
        "reportOrigin": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200",
              "code": "679978",
              "display": "Self",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/immunization-origin",
              "code": "recall",
              "display": "Parent/Guardian/Patient Recall",
              "userSelected": false
            }
          ],
          "text": "Self"
        },
        "location": {
          "reference": "Location/32545019",
          "display": "A"
        },
        "doseQuantity": {
          "value": 0.0,
          "unit": "unknown unit",
          "system": "http://unitsofmeasure.org",
          "code": "{unknownunit}"
        },
        "protocolApplied": [
          {
            "targetDisease": [
              {
                "coding": [
                  {
                    "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/4003106",
                    "code": "2289043429",
                    "display": "COVID-19",
                    "userSelected": true
                  },
                  {
                    "system": "http://hl7.org/fhir/sid/cvx",
                    "code": "213",
                    "display": "SARS-COV-2 (COVID-19) vaccine, UNSPECIFIED",
                    "userSelected": false
                  }
                ],
                "text": "COVID-19"
              }
            ],
            "doseNumberString": "Unknown"
          }
        ]
      }
    },
    {
      "fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/M197197982",
      "resource": {
        "resourceType": "Immunization",
        "id": "M197197982",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2019-12-26T13:12:59-06:00"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Immunization</b></p><p><b>Vaccine</b>: influenza virus vaccine, live</p><p><b>Occurrence</b>: 2019</p><p><b>Patient</b>: SMART, NANCY</p><p><b>Status</b>: Completed</p></div>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2820756",
              "display": "influenza virus vaccine, live",
              "userSelected": true
            },
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "111",
              "display": "influenza, live, intranasal",
              "userSelected": false
            }
          ],
          "text": "influenza virus vaccine, live"
        },
        "patient": {
          "reference": "Patient/12724066",
          "display": "SMART, NANCY"
        },
        "encounter": {
          "reference": "Encounter/97939518"
        },
        "occurrenceDateTime": "2019",
        "primarySource": false,
        "reportOrigin": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200",
              "code": "679978",
              "display": "Self",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/immunization-origin",
              "code": "recall",
              "display": "Parent/Guardian/Patient Recall",
              "userSelected": false
            }
          ],
          "text": "Self"
        },
        "location": {
          "reference": "Location/32545019",
          "display": "A"
        },
        "doseQuantity": {
          "value": 0.0,
          "unit": "unknown unit",
          "system": "http://unitsofmeasure.org",
          "code": "{unknownunit}"
        }
      }
    }
  ]
}

Retrieve by ID

List an individual immunization by the associated ID:

GET /Immunization/:id

Authorization Types

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/M197197986

Response

Status: 200 OK

{
  "resourceType": "Immunization",
  "id": "M197197986",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2019-12-26T13:12:59-06:00"
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Immunization</b></p><p><b>Vaccine</b>: tetanus toxoid</p><p><b>Occurrence</b>: 1982</p><p><b>Patient</b>: SMART, NANCY</p><p><b>Status</b>: Completed</p></div>"
  },
  "status": "completed",
  "vaccineCode": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
        "code": "2798767",
        "display": "tetanus toxoid",
        "userSelected": true
      },
      {
        "system": "http://hl7.org/fhir/sid/cvx",
        "code": "112",
        "display": "tetanus toxoid, unspecified formulation",
        "userSelected": false
      }
    ],
    "text": "tetanus toxoid"
  },
  "patient": {
    "reference": "Patient/12724066",
    "display": "SMART, NANCY"
  },
  "encounter": {
    "reference": "Encounter/97939518"
  },
  "occurrenceDateTime": "1982",
  "primarySource": false,
  "reportOrigin": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200",
        "code": "679978",
        "display": "Self",
        "userSelected": true
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/immunization-origin",
        "code": "recall",
        "display": "Parent/Guardian/Patient Recall",
        "userSelected": false
      }
    ],
    "text": "Self"
  },
  "location": {
    "reference": "Location/32545019",
    "display": "A"
  },
  "doseQuantity": {
    "value": 0.0,
    "unit": "unknown unit",
    "system": "http://unitsofmeasure.org",
    "code": "{unknownunit}"
  },
  "protocolApplied": [
    {
      "targetDisease": [
        {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/4003106",
              "code": "2289043429",
              "display": "COVID-19",
              "userSelected": true
            },
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "213",
              "display": "SARS-COV-2 (COVID-19) vaccine, UNSPECIFIED",
              "userSelected": false
            }
          ],
          "text": "COVID-19"
        }
      ],
      "doseNumberString": "Unknown"
    }
  ]
}

Patient Authorization Request For Completed Status

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/M197197986

Response

Status: 200 OK

{
  "resourceType": "Immunization",
  "id": "M197197986",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2019-12-26T13:12:59-06:00"
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Immunization</b></p><p><b>Vaccine</b>: tetanus toxoid</p><p><b>Occurrence</b>: 1982</p><p><b>Patient</b>: SMART, NANCY</p><p><b>Status</b>: Completed</p></div>"
  },
  "status": "completed",
  "vaccineCode": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
        "code": "2798767",
        "display": "tetanus toxoid",
        "userSelected": true
      },
      {
        "system": "http://hl7.org/fhir/sid/cvx",
        "code": "112",
        "display": "tetanus toxoid, unspecified formulation",
        "userSelected": false
      }
    ],
    "text": "tetanus toxoid"
  },
  "patient": {
    "reference": "Patient/12724066",
    "display": "SMART, NANCY"
  },
  "encounter": {
    "reference": "Encounter/97939518"
  },
  "occurrenceDateTime": "1982",
  "primarySource": false,
  "reportOrigin": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200",
        "code": "679978",
        "display": "Self",
        "userSelected": true
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/immunization-origin",
        "code": "recall",
        "display": "Parent/Guardian/Patient Recall",
        "userSelected": false
      }
    ],
    "text": "Self"
  },
  "location": {
    "reference": "Location/32545019",
    "display": "A"
  },
  "doseQuantity": {
    "value": 0.0,
    "unit": "unknown unit",
    "system": "http://unitsofmeasure.org",
    "code": "{unknownunit}"
  }
}

Patient Authorization Request For Entered in Error Status

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/M211860902

Response

Status: 200 OK

{
  "resourceType": "Immunization",
  "id": "M197197986",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2019-12-26T13:12:59-06:00"
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml'><p><b>Immunization</b></p><p><b>Patient</b>:MARSTON, JACK</p><p><b>Status</b>: Entered in Error</p></div>"
  },
  "status": "entered-in-error",
  "vaccineCode": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
        "code": "error",
        "display": "Error"
      }
    ],
    "text": "Error"
  },
  "patient": {
    "reference": "Patient/166045489",
    "display": "MARSTON, JACK"
  },
  "_occurrenceDateTime": {
    "extension": [
      {
        "valueCode": "error",
        "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
      }
    ]
  }
}

Patient Authorization Request For Not Done Status

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/HM178147794

Response

Status: 200 OK

{
  "resourceType": "Immunization",
  "id": "HM178147794",
  "meta": {
    "versionId": "0",
    "lastUpdated": "2020-09-09T12:55:55-05:00"
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Immunization</b></p><p><b>Vaccine</b>: Rotavirus</p><p><b>Occurrence</b>: Sep  9, 2020 12:55 P.M. CDT</p><p><b>Patient</b>: MARSTON, JACK</p><p><b>Status</b>: Not Done</p><p><b>Status Reason</b>: Patient Refuses</p></div>"
  },
  "status": "not-done",
  "statusReason": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200",
        "code": "679611",
        "display": "Patient Refuses",
        "userSelected": true
      },
      {
        "system": "http://snomed.info/sct",
        "code": "591000119102",
        "display": "Vaccine refused by patient (situation)",
        "userSelected": false
      }
    ],
    "text": "Patient Refuses"
  },
  "vaccineCode": {
    "text": "Rotavirus"
  },
  "patient": {
    "reference": "Patient/166045489",
    "display": "MARSTON, JACK"
  },
  "occurrenceDateTime": "2020-09-09T12:55:55-05:00",
  "primarySource": true
}

Create

Create a new immunization.

POST /Immunization

Authorization Types

Headers

Authorization: <OAuth2 Bearer Token>
Content-Type: application/fhir+json

Body Fields

Name	Required	Type
resourceType	Yes	string
Description The type of the FHIR resource. Example { "resourceType": "Immunization" } Notes resourceType must be Immunization top of section
status	Yes	code
Description Indicates the current status of the immunization event. Example { "status": "completed" } top of section
statusReason	No	CodeableConcept
Description Reason the immunization was not performed. Example { "statusReason": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30440", "code": "679607", "display": "Patient Refuses", "userSelected": true } ], "text": "Patient Refuses" } } Notes This is generally only used for the status of "not-done". top of section
vaccineCode	Yes	CodeableConcept
Description The vaccine that was administered or was to be administered. Example { "vaccineCode": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72", "code": "2797921", "display": "hepatitis A-hepatitis B vaccine", "userSelected": false } ], "text": "hepatitis A-hepatitis B vaccine" } } top of section
patient	Yes	Reference
Description The patient who either received or did not receive the immunization. Example { "patient": { "reference": "Patient/123820084", "display": "Immun, Test1" } } top of section
encounter	Yes	Reference
Description The visit or admission or other contact between patient and health care provider the immunization was performed as part of. Example { "encounter": { "reference": "Encounter/36209678" } } Notes encounter is required field to create charted immunizations. encounter is not a required field to create staged immunizations. top of section
occurrenceDateTime	Yes	dateTime
Description Date vaccine administered or was to be administered. Example { "occurrenceDateTime": "2019-07-05T10:35:00-05:00" } top of section
reportOrigin	No	CodeableConcept
Description The source of an immunization record when not reported by the person who administered the vaccine. Example { "reportOrigin": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200", "code": "20738688", "display": "Primary Care Provider", "userSelected": false } ], "text": "Primary Care Provider" } } Notes Should not be supplied when primarySource is set to true. top of section
manufacturer	No	Reference
Description Name of vaccine manufacturer. Example { "manufacturer": { "display": "Adams Laboratories" } } top of section
lotNumber	No	string
Description Lot number of the vaccine product. Example { "lotNumber": "123ab", } top of section
expirationDate	No	date
Description Date vaccine batch expires. Example { "expirationDate": "2019-07-30" } top of section
site	No	CodeableConcept
Description The body site where the vaccine was administered. Example { "site": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/97", "code": "576", "display": "Left Arm", "userSelected": false } ], "text": "Left Arm" } } top of section
route	No	CodeableConcept
Description The path by which the vaccine product was taken into the body. Example { "route": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/4001", "code": "318167", "display": "IM", "userSelected": false } ], "text": "IM" } } top of section
doseQuantity	No	SimpleQuantity
Description The quantity of vaccine product that was administered. Example { "doseQuantity": { "value": 1.5, "unit": "mL", "system": "http://unitsofmeasure.org", "code": "mL" } } top of section
performer	No	List of BackboneElement
Description Indicates who performed the immunization event. Example { "performer": [ { "function": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0443", "code": "AP", "display": "Administering Provider" } ], "text": "Administering Provider" }, "actor": { "reference": "Practitioner/7750958", "display": "Doe, John" } } ] } top of section
performer.function	No	CodeableConcept
Description Describes the type of performance (e.g. ordering provider, administering provider, etc.). Example { "function": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0443", "code": "OP", "display": "Ordering Provider" } ], "text": "Ordering Provider" } } top of section
performer.actor	Yes	Reference
Description The practitioner or organization who performed the action. Example { "actor": { "reference": "Practitioner/7750958", "display": "Doe, John" } } top of section
note	No	List of Annotation
Description Extra information about the immunization that is not conveyed by the other attributes. Example { "authorReference": { "reference": "Practitioner/2028012", "display": "Doe, Jane" }, "time": "2019-06-09T14:03:26-05:00", "text": "Additional details" } top of section
primarySource	No	boolean
Description An indication that the content of the record is based on information from the person who administered the vaccine. Example { "primarySource": true } Notes Will be set to true if not specified. For CREATE action should not be set to true when reportOrigin is populated. For UPDATE action should not be set to true. top of section

Example

Request

POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization

Body

{
  "resourceType": "Immunization",
  "status": "completed",
  "occurrenceDateTime": "2019-06-30T10:35:00-05:00",
  "vaccineCode": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
        "code": "2798767",
        "display": "tetanus toxoid",
        "userSelected": false
      }
    ],
    "text": "tetanus toxoid"
  },
  "patient": {
    "reference": "Patient/12724066"
  },
  "encounter": {
    "reference": "Encounter/97939518"
  },
  "reportOrigin": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200",
        "code": "679978",
        "display": "Self",
        "userSelected": true
      }
    ],
    "text": "Self"
  },
  "site": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/97",
        "code": "610",
        "display": "Right Hand",
        "userSelected": false
      }
    ],
    "text": "Right Hand"
  },
  "route": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/4001",
        "code": "318167",
        "display": "IM",
        "userSelected": false
      }
    ],
    "text": "IM"
  }
}

Response

Status: 201 Created

Cache-Control: no-cache
Content-Length: 0
Content-Type: application/fhir+json
Date: Sun, 30 Jun 2019 10:35:00 GMT
Etag: W/"1"
Last-Modified: Sun, 30 Jun 2019 10:35:00 GMT
Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/147391087
Vary: Origin
opc-request-id: /11111111111111111111111111111111/11111111111111111111111111111111
X-Request-Id: 11111111-1111-1111-1111-111111111111

The ETag response header indicates the current If-Match version to use on subsequent updates.

Update

Update an immunization.

PUT /Immunization/:id

Authorization Types

Headers

Authorization: <OAuth2 Bearer Token>
Content-Type: application/fhir+json
If-Match: W/"<Current version of the Immunization resource>"

Body fields

Name	Required	Type
resourceType	Yes	string
Description The type of the FHIR resource. Example { "resourceType": "Immunization" } Notes resourceType must be Immunization top of section
id	Yes	id
Description The logical id of the resource. Example { "id": "M43434511" } top of section
status	Yes	code
Description Indicates the current status of the immunization event. Example { "status": "completed" } top of section
statusReason	No	CodeableConcept
Description Reason the immunization was not performed. Example { "statusReason": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30440", "code": "679607", "display": "Patient Refuses", "userSelected": true } ], "text": "Patient Refuses" } } Notes This is generally only used for the status of "not-done". top of section
vaccineCode	Yes	CodeableConcept
Description The vaccine that was administered or was to be administered. Example { "vaccineCode": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72", "code": "2797921", "display": "hepatitis A-hepatitis B vaccine", "userSelected": false } ], "text": "hepatitis A-hepatitis B vaccine" } } top of section
patient	Yes	Reference
Description The patient who either received or did not receive the immunization. Example { "patient": { "reference": "Patient/123820084", "display": "Immun, Test1" } } top of section
encounter	Yes	Reference
Description The visit or admission or other contact between patient and health care provider the immunization was performed as part of. Example { "encounter": { "reference": "Encounter/36209678" } } top of section
occurrenceDateTime	Yes	dateTime
Description Date vaccine administered or was to be administered. Example { "occurrenceDateTime": "2019-07-05T10:35:00-05:00" } top of section
reportOrigin	No	CodeableConcept
Description The source of an immunization record when not reported by the person who administered the vaccine. Example { "reportOrigin": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200", "code": "20738688", "display": "Primary Care Provider", "userSelected": false } ], "text": "Primary Care Provider" } } Notes Should not be supplied when primarySource is set to true. top of section
manufacturer	No	Reference
Description Name of vaccine manufacturer. Example { "manufacturer": { "display": "Adams Laboratories" } } top of section
lotNumber	No	string
Description Lot number of the vaccine product. Example { "lotNumber": "123ab", } top of section
expirationDate	No	date
Description Date vaccine batch expires. Example { "expirationDate": "2019-07-30" } top of section
site	No	CodeableConcept
Description The body site where the vaccine was administered. Example { "site": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/97", "code": "576", "display": "Left Arm", "userSelected": false } ], "text": "Left Arm" } } top of section
route	No	CodeableConcept
Description The path by which the vaccine product was taken into the body. Example { "route": { "coding": [ { "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/4001", "code": "318167", "display": "IM", "userSelected": false } ], "text": "IM" } } top of section
doseQuantity	No	SimpleQuantity
Description The quantity of vaccine product that was administered. Example { "doseQuantity": { "value": 1.5, "unit": "mL", "system": "http://unitsofmeasure.org", "code": "mL" } } top of section
performer	No	List of BackboneElement
Description Indicates who performed the immunization event. Example { "performer": [ { "function": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0443", "code": "AP", "display": "Administering Provider" } ], "text": "Administering Provider" }, "actor": { "reference": "Practitioner/7750958", "display": "Doe, John" } } ] } top of section
performer.function	No	CodeableConcept
Description Describes the type of performance (e.g. ordering provider, administering provider, etc.). Example { "function": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0443", "code": "OP", "display": "Ordering Provider" } ], "text": "Ordering Provider" } } top of section
performer.actor	Yes	Reference
Description The practitioner or organization who performed the action. Example { "actor": { "reference": "Practitioner/7750958", "display": "Doe, John" } } top of section
note	No	List of Annotation
Description Extra information about the immunization that is not conveyed by the other attributes. Example { "authorReference": { "reference": "Practitioner/2028012", "display": "Doe, Jane" }, "time": "2019-06-09T14:03:26-05:00", "text": "Additional details" } top of section
primarySource	No	boolean
Description An indication that the content of the record is based on information from the person who administered the vaccine. Example { "primarySource": true } Notes Will be set to true if not specified. For CREATE action should not be set to true when reportOrigin is populated. For UPDATE action should not be set to true. top of section

Example

Request

PUT https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Immunization/M197197986

Body

{
  "resourceType": "Immunization",
  "id": "M197197986",
  "status": "completed",
  "occurrenceDateTime": "2019-07-15T10:35:00-05:00",
  "vaccineCode": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
        "code": "2798767",
        "display": "tetanus toxoid",
        "userSelected": true
      }
    ],
    "text": "tetanus toxoid"
  },
  "patient": {
    "reference": "Patient/12724066"
  },
  "encounter": {
    "reference": "Encounter/97939518"
  },
  "reportOrigin": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/30200",
        "code": "679978",
        "display": "Self",
        "userSelected": true
      }
    ],
    "text": "Self"
  },
  "performer": [
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "AP",
            "display": "Administering Provider"
          }
        ],
        "text": "Administering Provider"
      },
      "actor": {
        "reference": "Practitioner/4122622"
      }
    }
  ]
}

Response

Status: 200 OK

Cache-Control: no-cache
Content-Length: 0
Content-Type: application/fhir+json
Date: Sun, 30 Jun 2019 10:40:00 GMT
Etag: W/"2"
Last-Modified: Sun, 30 Jun 2019 10:40:00 GMT
Vary: Origin
X-Request-Id: b72617f9-1a52-46ca-bb52-b0b3f976f9fb

The ETag response header indicates the current If-Match version to use on subsequent updates.