Immunization

Overview

For the Immunization resource query, the API returns a consolidated list of immunizations charted as complete (administered, not administered or historical) for the patient. The list may include immunizations administered internally and/or those externally reported as administered, including records reconciled from external sources such as the patient, state registries and/or consolidated clinical document architecture (C-CDA) documents. The API does not return immunizations that may be ordered or scheduled but not yet administered.

The information available for immunization records may vary depending on their source; for example, immunizations administered locally or as reconciled from a registry record may include ingredient details, codes, precise administration dates, etc. while an immunization reported by a patient or as received in a C-CDA may not. The API will return the level of detail charted.

The dates associated with immunizations may reflect both charted dates and administration dates which are most likely the same for internally administered records but will vary for externally sourced records. Further, administration dates may vary in precision and accuracy depending on the source; specifically patient expressed dates may be fuzzy dates. To avoid ambiguity of intended date context, the API will always return all configured and charted records; no date/date range parameters are supported.

Terminology Bindings

Immunization.vaccineCode
  • Description
    • Identifies the vaccine substance administered.
  • Details: CVX
    System: http://hl7.org/fhir/sid/cvx

  • Details: NDC
    System: http://hl7.org/fhir/sid/ndc

Custom Extensions

The bundle extension can be returned, see possible codes in the errors section below.

GET /Immunization?:parameters

Implementation Notes

Parameters

Name Required? Type Description
patientId Y reference The patient identifier provided in a pre-requisite authorization step.

Headers

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

Example

Request

GET https://fhir-myrecord.sandboxcerner.com/dstu2/123abc/Immunization?patientId=52930295-B52D-4685-B922-DC5F181CF786

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "debcb450-dcf0-492d-8768-eb8360c159e2",
  "meta": {
    "lastUpdated": "2017-02-28T11:15:03.930-05:00"
  },
  "extension": [
    {
      "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
      "valueExtension": {
        "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
        "extension": [
          {
            "url": "Severity",
            "valueString": "info"
          },
          {
            "url": "Code",
            "valueString": "papi009"
          },
          {
            "url": "Message",
            "valueString": "This is the most current, known Immunization list and may not reflect the state of immunizations known at a previous date."
          }
        ]
      }
    }
  ],
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "base-url/123abc/Immunization?patientId=52930295-B52D-4685-B922-DC5F181CF786&_format=json"
    }
  ],
  "entry": [
    {
      "resource": {
        "resourceType": "Immunization",
        "text": {
          "status": "additional",
          "div": "<li ccdRefId='ZImmunizations.Immunizations.10400115510'><b>FLU VAC TV 2015(18 YR+)RCM/PF</b> (FLUBLOK 2015-2016, ABBVIE US LLC, Lot # 124578AQ); Administered 2/28/2017 11:16 AM; 135 MCG = 0.5 ML, Intramuscular</li>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "155",
              "display": "FLU VAC TV 2015(18 YR+)RCM/PF"
            },
            {
              "system": "http://hl7.org/fhir/sid/ndc",
              "code": "42874-0015-10",
              "display": "FLU VAC TV 2015(18 YR+)RCM/PF"
            }
          ],
          "text": "FLU VAC TV 2015(18 YR+)RCM/PF"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "wasNotGiven": false,
        "reported": true
      }
    },
    {
      "resource": {
        "resourceType": "Immunization",
        "text": {
          "status": "additional",
          "div": "<li ccdRefId='ZImmunizations.Immunizations.1040014511'><b>Hep B, NOS</b> (ABBVIE US LLC, Lot # 124578A); Administered 2/28/2017 12:00 AM; 0.5 ml, Intramuscular</li>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "45",
              "display": "Hep B, NOS"
            }
          ],
          "text": "Hep B, NOS"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "wasNotGiven": false,
        "reported": true
      }
    },
    {
      "resource": {
        "resourceType": "Immunization",
        "text": {
          "status": "additional",
          "div": "<li ccdRefId='ZImmunizations.Immunizations.10400110612'><b>DTaP, 5 pertussis antigens</b> Administered 10/5/2015 12:00 AM</li>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "106",
              "display": "DTaP, 5 pertussis antigens"
            }
          ],
          "text": "DTaP, 5 pertussis antigens"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "wasNotGiven": false,
        "reported": true
      }
    },
    {
      "resource": {
        "resourceType": "Immunization",
        "text": {
          "status": "additional",
          "div": "<li ccdRefId='ZImmunizations.Immunizations.1040012013'><b>DTaP</b> Not Administered 10/8/2014 12:00 AM; Patient decision</li>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "20",
              "display": "DTaP"
            }
          ],
          "text": "DTaP"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "wasNotGiven": true,
        "reported": true
      }
    },
    {
      "resource": {
        "resourceType": "Immunization",
        "text": {
          "status": "additional",
          "div": "<li ccdRefId='ZImmunizations.Immunizations.10400116614'><b>influenza, intradermal, quadrivalent, PF</b> Not Administered 10/1/2014 12:00 AM; Parental decision</li>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "166",
              "display": "influenza, intradermal, quadrivalent, PF"
            }
          ],
          "text": "influenza, intradermal, quadrivalent, PF"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "wasNotGiven": true,
        "reported": true
      }
    },
    {
      "resource": {
        "resourceType": "Immunization",
        "text": {
          "status": "additional",
          "div": "<li ccdRefId='ZImmunizations.Immunizations.1040018815'><b>influenza, NOS</b> Administered 5/10/2014 12:00 AM</li>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "88",
              "display": "influenza, NOS"
            }
          ],
          "text": "influenza, NOS"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "wasNotGiven": false,
        "reported": true
      }
    },
    {
      "resource": {
        "resourceType": "Immunization",
        "text": {
          "status": "additional",
          "div": "<li ccdRefId='ZImmunizations.Immunizations.1040013516'><b>tetanus toxoid</b> Administered 10/2/2013 12:00 AM</li>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "35",
              "display": "tetanus toxoid"
            }
          ],
          "text": "tetanus toxoid"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "wasNotGiven": false,
        "reported": true
      }
    },
    {
      "resource": {
        "resourceType": "Immunization",
        "text": {
          "status": "additional",
          "div": "<li ccdRefId='ZImmunizations.Immunizations.10400111217'><b>tetanus toxoid, NOS</b> Administered 1/4/2012 12:00 AM</li>"
        },
        "status": "completed",
        "vaccineCode": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/cvx",
              "code": "112",
              "display": "tetanus toxoid, NOS"
            }
          ],
          "text": "tetanus toxoid, NOS"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "wasNotGiven": false,
        "reported": true
      }
    }
  ]
}

Errors and Informational messages

The common errors and informational messages can be returned.

These additional informational messages may be returned within the bundle extension:

Code Message
papi009 This is the most current, known Immunization list and may not reflect the state of immunizations known at a previous date.
papi010 No relevant immunizations exist.
papi030 No immunization information could be retrieved.