Amakomaya Nepal FHIR Implementation Guide
1.0.1 - ci-build

Amakomaya Nepal FHIR Implementation Guide - Local Development build (v1.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: AMKCoreImmunizationProfile - XML Profile

Active as of 2026-06-15

XML representation of the amk-core-immunization resource profile.

Raw xml | Download

    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="amk-core-immunization"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition amk-core-immunization</b></p><a name="amk-core-immunization"> </a><a name="hcamk-core-immunization"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-amk-core-immunization-definitions.html#Immunization">Immunization</a><a name="Immunization"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/immunization.html">Immunization</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Immunization event information</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-amk-core-immunization-definitions.html#Immunization.status">status</a><a name="Immunization.status"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R5/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">completed | entered-in-error | not-done</span><br/><span style="font-weight:bold">Required Pattern: </span><span style="color: darkgreen">completed</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-amk-core-immunization-definitions.html#Immunization.vaccineCode">vaccineCode</a><a name="Immunization.vaccineCode"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R5/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Vaccine administered</span><br class="binding"/><span style="font-weight:bold" title="null" class="binding">Binding: </span><a href="ValueSet-vaccine.html" title="https://fhir.amakomaya.com/ValueSet/vaccine" class="binding">Vaccines (SNOMED CT)</a><span title="null" class="binding"> (</span><a href="http://hl7.org/fhir/R5/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set." class="binding">required</a><span title="null" class="binding">)</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-amk-core-immunization-definitions.html#Immunization.patient">patient</a><a name="Immunization.patient"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/references.html">Reference</a>(<a href="StructureDefinition-amk-core-patient.html">AMK Core Patient Profile</a>)</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Who was immunized</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck03.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: white; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic; font-style: italic" href="StructureDefinition-amk-core-immunization-definitions.html#Immunization.occurrence[x]">Slices for occurrence[x]</a><a name="Immunization.occurrence_x_"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="opacity: 0.5; font-style: italic">1</span><span style="opacity: 0.5; font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; font-style: italic; opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R5/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">Vaccine administration date</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by type:$this</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck024.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-amk-core-immunization-definitions.html#Immunization.occurrence[x]:occurrenceDateTime" title="Slice occurrenceDateTime">occurrence[x]:occurrenceDateTime</a><a name="Immunization.occurrence_x_:occurrenceDateTime"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Vaccine administration date</span></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <url
           value="https://fhir.amakomaya.com/StructureDefinition/amk-core-immunization"/>
      <version value="1.0.1"/>
      <name value="AMKCoreImmunizationProfile"/>
      <title value="AMK Core Immunization Profile"/>
      <status value="active"/>
      <date value="2026-06-15T14:57:41+05:45"/>
      <publisher value="Amakomaya Nepal"/>
      <contact>
        <name value="Amakomaya Nepal"/>
        <telecom>
          <system value="url"/>
          <value value="https://amakomaya.com"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="info@amakomaya.com"/>
        </telecom>
      </contact>
      <contact>
        <name value="RC Poudel"/>
        <telecom>
          <system value="email"/>
          <value value="rcpoudel@amakomaya.com"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="rmchndrapdl@gmail.com"/>
        </telecom>
        <telecom>
          <system value="phone"/>
          <value value="+977-9851341921"/>
        </telecom>
      </contact>
      <description
                   value="The AMK Core Immunization Profile inherits from the FHIR [Immunization](https://hl7.org/fhir/R5/immunization.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Immunization resource to record, search, and fetch basic immunization information for an individual patient within the Nepal health system. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. By providing a standardized foundation for capturing immunization events in Nepal"/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="NP"/>
        </coding>
      </jurisdiction>
      <copyright
                 value="Used by permission of HL7 International, all rights reserved Creative Commons License"/>
      <fhirVersion value="5.0.0"/>
      <mapping>
        <identity value="workflow"/>
        <uri value="http://hl7.org/fhir/workflow"/>
        <name value="Workflow Pattern"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <uri value="http://hl7.org/fhir/fivews"/>
        <name value="FiveWs Pattern Mapping"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <uri value="http://hl7.org/v2"/>
        <name value="HL7 V2 Mapping"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <uri value="http://hl7.org/v3"/>
        <name value="RIM Mapping"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <uri value="http://hl7.org/v3/cda"/>
        <name value="CDA (R2)"/>
      </mapping>
      <kind value="resource"/>
      <abstract value="false"/>
      <type value="Immunization"/>
      <baseDefinition
                      value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
      <derivation value="constraint"/>
      <snapshot>
        <extension
                   url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
          <valueString value="5.0.0"/>
        </extension>
        <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()"/>
            <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((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
            <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()"/>
            <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()"/>
            <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()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Entity, Role, or Act,SubstanceAdministration"/>
          </mapping>
          <mapping>
            <identity value="workflow"/>
            <map value="Event"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="clinical.medication"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map value="VXU_V04"/>
          </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="Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case."/>
          <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="id"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Immunization.meta">
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </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 its 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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <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 its meaning or interpretation"/>
          <isSummary value="true"/>
        </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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="Language"/>
            </extension>
            <strength value="required"/>
            <description value="IETF language tag for a human language"/>
            <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0"/>
            <additional>
              <purpose value="starter"/>
              <valueSet value="http://hl7.org/fhir/ValueSet/languages|5.0.0"/>
            </additional>
          </binding>
        </element>
        <element id="Immunization.text">
          <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 a 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="dom-6"/>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning."/>
          <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>
          <condition value="dom-2"/>
          <condition value="dom-4"/>
          <condition value="dom-3"/>
          <condition value="dom-5"/>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Immunization.extension">
          <path value="Immunization.extension"/>
          <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 managable, 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>
          <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())"/>
            <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()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Immunization.modifierExtension">
          <path value="Immunization.modifierExtension"/>
          <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's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <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](http://hl7.org/fhir/R5/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>
          <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())"/>
            <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()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Immunization.identifier">
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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.basedOn">
          <path value="Immunization.basedOn"/>
          <short value="Authority that the immunization event is based on"/>
          <definition
                      value="A plan, order or recommendation fulfilled in whole or in part by this immunization."/>
          <comment
                   value="Allows tracing of an authorization for the Immunization."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Immunization.basedOn"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/CarePlan|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/MedicationRequest|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/ServiceRequest|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.basedOn"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </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>
          <patternCode value="completed"/>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <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"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-status|5.0.0"/>
          </binding>
          <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">
          <path value="Immunization.statusReason"/>
          <short value="Reason for current status"/>
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImmunizationStatusReason"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-status-reason|5.0.0"/>
          </binding>
          <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">
          <path value="Immunization.vaccineCode"/>
          <short value="Vaccine administered"/>
          <definition
                      value="Vaccine that was administered or was to be administered."/>
          <comment
                   value="The code for the administered vaccine may be reported at various levels of granularity from a very generic code for a general type of vaccine (e.g. the SNOMED or CVX code for the flu vaccine) to a very discrete code for a specific product including the form and packaging (e.g. an NDC code). Because vaccineCode uses the CodeableConcept data type, multiple codes at different levels of granularity may be reported for a single immunization event provided that all codes are appropriate for the same vaccine. For example, both NDC and CVX codes may be provided for a given immunization event by repeating the coding element within vaccineCode."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Immunization.vaccineCode"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <strength value="required"/>
            <valueSet value="https://fhir.amakomaya.com/ValueSet/vaccine"/>
          </binding>
          <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.administeredProduct">
          <path value="Immunization.administeredProduct"/>
          <short value="Product that was administered"/>
          <definition
                      value="An indication of which product was administered to the patient. This is typically a more detailed representation of the concept conveyed by the vaccineCode data element. If a Medication resource is referenced, it may be to a stand-alone resource or a contained resource within the Immunization resource."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.administeredProduct"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableReference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Medication|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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.manufacturer">
          <path value="Immunization.manufacturer"/>
          <short value="Vaccine manufacturer"/>
          <definition value="Name of vaccine manufacturer."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.manufacturer"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableReference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.lotNumber"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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.patient">
          <path value="Immunization.patient"/>
          <short value="Who was immunized"/>
          <definition
                      value="The patient who either received or did not receive the immunization."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Immunization.patient"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="https://fhir.amakomaya.com/StructureDefinition/amk-core-patient"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <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>
        </element>
        <element id="Immunization.encounter">
          <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."/>
          <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|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.encounter"/>
          </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.supportingInformation">
          <path value="Immunization.supportingInformation"/>
          <short value="Additional information in support of the immunization"/>
          <definition
                      value="Additional information that is relevant to the immunization (e.g. for a vaccine recipient who is pregnant, the gestational age of the fetus). The reason why a vaccine was given (e.g. occupation, underlying medical condition) should be conveyed in Immunization.reason, not as supporting information. The reason why a vaccine was not given (e.g. contraindication) should be conveyed in Immunization.statusReason, not as supporting information."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Immunization.supportingInformation"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.context"/>
          </mapping>
        </element>
        <element id="Immunization.occurrence[x]">
          <path value="Immunization.occurrence[x]"/>
          <slicing>
            <discriminator>
              <type value="type"/>
              <path value="$this"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="closed"/>
          </slicing>
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <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.occurrence[x]:occurrenceDateTime">
          <path value="Immunization.occurrence[x]"/>
          <sliceName value="occurrenceDateTime"/>
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <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.primarySource">
          <path value="Immunization.primarySource"/>
          <short value="Indicates context the data was captured in"/>
          <definition
                      value="Indicates whether the data contained in the resource was captured by the individual/organization which was responsible for the administration of the vaccine rather than as 'secondary reported' data documented by a third party. A value of 'true' means this data originated with the individual/organization which was responsible for the administration of the vaccine."/>
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.reported"/>
          </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.informationSource">
          <path value="Immunization.informationSource"/>
          <short value="Indicates the source of a  reported record"/>
          <definition
                      value="Typically 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="Typically will not be populated if primarySource = True, not required even if primarySource = False."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.informationSource"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableReference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/RelatedPerson|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImmunizationReportOrigin"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-origin|5.0.0"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.reported"/>
          </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">
          <path value="Immunization.location"/>
          <short value="Where immunization occurred"/>
          <definition
                      value="The service delivery location where the vaccine administration occurred."/>
          <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|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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.site">
          <path value="Immunization.site"/>
          <short value="Body site vaccine  was administered"/>
          <definition value="Body site where vaccine was administered."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.site"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImmunizationSite"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-site|5.0.0"/>
          </binding>
          <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">
          <path value="Immunization.route"/>
          <short value="How vaccine entered body"/>
          <definition
                      value="The path by which the vaccine product is taken into the body."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.route"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImmunizationRoute"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-route|5.0.0"/>
          </binding>
          <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">
          <path value="Immunization.doseQuantity"/>
          <short value="Amount of vaccine administered"/>
          <definition
                      value="The quantity of vaccine product that was administered."/>
          <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|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="RXA-6 / RXA-7"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".doseQuantity"/>
          </mapping>
        </element>
        <element id="Immunization.performer">
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <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>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.performer.extension">
          <path value="Immunization.performer.extension"/>
          <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 managable, 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>
          <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())"/>
            <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()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.performer.modifierExtension">
          <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's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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.

    Modifier 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](http://hl7.org/fhir/R5/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>
          <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())"/>
            <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()"/>
            <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>
        </element>
        <element id="Immunization.performer.function">
          <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.)."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.performer.function"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImmunizationFunction"/>
            </extension>
            <strength value="extensible"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-function|5.0.0"/>
          </binding>
          <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">
          <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|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/RelatedPerson|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <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">
          <path value="Immunization.note"/>
          <short value="Additional immunization notes"/>
          <definition
                      value="Extra information about the immunization that is not conveyed by the other attributes."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Immunization.note"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Annotation"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <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.reason">
          <path value="Immunization.reason"/>
          <short value="Why immunization occurred"/>
          <definition
                      value="Describes why the immunization occurred in coded or textual form, or Indicates another resource (Condition, Observation or DiagnosticReport) whose existence justifies this immunization."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Immunization.reason"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableReference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Condition|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Observation|5.0.0"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ImmunizationReason"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-reason|5.0.0"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.reason"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="[actionNegationInd=false].reasonCode"/>
          </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."/>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="true"/>
          <isModifierReason
                            value="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 value="true"/>
          <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">
          <path value="Immunization.subpotentReason"/>
          <short value="Reason for being subpotent"/>
          <definition value="Reason why a dose is considered to be subpotent."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Immunization.subpotentReason"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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|5.0.0"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Immunization.programEligibility">
          <path value="Immunization.programEligibility"/>
          <short value="Patient eligibility for a specific vaccination program"/>
          <definition
                      value="Indicates a patient's eligibility for a funding program."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Immunization.programEligibility"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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.programEligibility.id">
          <path value="Immunization.programEligibility.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>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.programEligibility.extension">
          <path value="Immunization.programEligibility.extension"/>
          <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 managable, 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>
          <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())"/>
            <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()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.programEligibility.modifierExtension">
          <path value="Immunization.programEligibility.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's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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.

    Modifier 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](http://hl7.org/fhir/R5/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>
          <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())"/>
            <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()"/>
            <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>
        </element>
        <element id="Immunization.programEligibility.program">
          <path value="Immunization.programEligibility.program"/>
          <short value="The program that eligibility is declared for"/>
          <definition
                      value="Indicates which program the patient had their eligility evaluated for."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Immunization.programEligibility.program"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="VaccineFundingProgram"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-vaccine-funding-program|5.0.0"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.programEligibility.programStatus">
          <path value="Immunization.programEligibility.programStatus"/>
          <short value="The patient's eligibility status for the program"/>
          <definition
                      value="Indicates the patient's eligility status for for a specific payment program."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Immunization.programEligibility.programStatus"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ProgramEligibility"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-program-eligibility|5.0.0"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.fundingSource">
          <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)."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.fundingSource"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="FundingSource"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-funding-source|5.0.0"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Immunization.reaction">
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.reaction.extension">
          <path value="Immunization.reaction.extension"/>
          <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 managable, 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>
          <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())"/>
            <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()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.reaction.modifierExtension">
          <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's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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.

    Modifier 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](http://hl7.org/fhir/R5/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>
          <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())"/>
            <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()"/>
            <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>
        </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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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.manifestation">
          <path value="Immunization.reaction.manifestation"/>
          <short value="Additional information on reaction"/>
          <definition value="Details of the reaction."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.reaction.manifestation"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableReference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Observation|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="(HL7 V2 doesn'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">
          <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>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <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>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.protocolApplied.extension">
          <path value="Immunization.protocolApplied.extension"/>
          <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 managable, 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>
          <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())"/>
            <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()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Immunization.protocolApplied.modifierExtension">
          <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's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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.

    Modifier 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](http://hl7.org/fhir/R5/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>
          <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())"/>
            <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()"/>
            <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>
        </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."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.protocolApplied.series"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Immunization.protocolApplied.authority">
          <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."/>
          <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|5.0.0"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Immunization.protocolApplied.targetDisease">
          <path value="Immunization.protocolApplied.targetDisease"/>
          <short value="Vaccine preventatable disease being targeted"/>
          <definition
                      value="The vaccine preventable disease the dose is being administered against."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Immunization.protocolApplied.targetDisease"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="TargetDisease"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/immunization-target-disease|5.0.0"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Immunization.protocolApplied.doseNumber">
          <path value="Immunization.protocolApplied.doseNumber"/>
          <short value="Dose number within series"/>
          <definition
                      value="Nominal position in a series as intended by the practitioner administering the dose."/>
          <comment
                   value="The use of an integer is preferred if known. Text 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"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Immunization.protocolApplied.seriesDoses">
          <path value="Immunization.protocolApplied.seriesDoses"/>
          <short value="Recommended number of doses for immunity"/>
          <definition
                      value="The recommended number of doses to achieve immunity as intended by the practitioner administering the dose."/>
          <comment value="The use of an integer is preferred if known."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Immunization.protocolApplied.seriesDoses"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <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())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
      </snapshot>
      <differential>
        <element id="Immunization">
          <path value="Immunization"/>
        </element>
        <element id="Immunization.status">
          <path value="Immunization.status"/>
          <patternCode value="completed"/>
        </element>
        <element id="Immunization.vaccineCode">
          <path value="Immunization.vaccineCode"/>
          <binding>
            <strength value="required"/>
            <valueSet value="https://fhir.amakomaya.com/ValueSet/vaccine"/>
          </binding>
        </element>
        <element id="Immunization.patient">
          <path value="Immunization.patient"/>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="https://fhir.amakomaya.com/StructureDefinition/amk-core-patient"/>
          </type>
        </element>
        <element id="Immunization.occurrence[x]">
          <path value="Immunization.occurrence[x]"/>
          <slicing>
            <discriminator>
              <type value="type"/>
              <path value="$this"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="open"/>
          </slicing>
        </element>
        <element id="Immunization.occurrence[x]:occurrenceDateTime">
          <path value="Immunization.occurrence[x]"/>
          <sliceName value="occurrenceDateTime"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="dateTime"/>
          </type>
        </element>
      </differential>
    </StructureDefinition>