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Immunization (QDM)

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QDM defines Immunization as vaccines administered to patients in healthcare settings but does not include non-vaccine agents. QDM defines two contexts for immunization: Immunization, Administered; Immunization, Order.

The HL7 CQI Workgroup reviewed and updated this content on April 24, 2018 based on QDM version 5.3. The content was updated on June 7, 2018 consistent with QDM version 5.4. The only change between QDM versions 5.3 and 5.4 is that version 5.4 removes the "supply" attribute from "Immunization, Administered" and retains the "supply" attribute for "Immunization, Order"

FHIR Immunization Recommendation resource is specifically designed to provide an immunization forecast from a forecasting engine to a provider, basically to carry clinical decision support recommendations specific to immunizations and, therefore, is not consistent with the intent of the QDM datatype "Immunization, Order". The most closely associated resource is MedicationRequest. There is no comparable FHIR resource to specify ImmunizationRequest.

Immunization, Administered

QDM Attribute QI Core Metadata Element Comment
Immunization, Administered Immunization (the .status metadata allows conformance to the specific QDM datatype context) QDM matched to QI Core / FHIR
Dosage Immunization.doseQuantity QDM matched to QI Core / FHIR
Negation Rationale Immunization.explanation.reasonNotGiven QDM matched to QI Core / FHIR
Reason Immunization.explanation.reason QDM matched to QI Core / FHIR
Route Immunization.route QDM matched to QI Core / FHIR
Author dateTime QDM matched to QI Core / FHIR

NOTE: See QDM Known Issues for update – Immunization, Administered should include only the dateTime of the immunization administration. Until QDM 5.5 version, implementers should map Immunization, Administered author dateTime to administrationTime. [1]

Code Immunization.vaccineCode QDM matched to QI Core / FHIR
id QDM matched to QI Core / FHIR
Source Immunization.primarySource Source addressed by primarySource or reportOrigin

Immunization, Order

QDM Attribute QI Core Metadata Element Comment
Immunization, Order MedicationRequest.intent Medication Request intent uses the concepts proposal, plan, order, original-order, reflex-order, filler-order, instance-order, option. Constrain to "order" from the intent value set for QDM datatypes with the order context.
Active dateTime MedicationRequest.dispenseRequest.validityPeriod This indicates the validity period of a prescription (stale dating the Prescription).
Dosage MedicationRequest.dosageInstruction Indicates how the medication is to be used by the patient.
Negation Rationale MedicationStatement.reasonNotTaken Medication Request in QI Core does not reference negation rationale. See FHIR Tracker Item 15941 addressing notDoneReason requirement.
Reason MedicationRequest.reasonCode QDM matched to QI Core / FHIR
Route MedicationRequest.dosageInstruction.route QDM matched to QI Core / FHIR.
Author dateTime MedicationRequest.authoredOn QDM matched to QI Core / FHIR

Note: FHIR Provenance generally addresses the author of the message; the identifier/source of the original resource element is defined by the resource. Individual resource element provenance is summarized in the FHIR W5 Report (

Supply MedicationRequest.dispenseRequest.quantity QDM matched to QI Core / FHIR.
Code MedicationRequest.medication QDM matched to QI Core / FHIR
id QDM matched to QI Core / FHIR
Source MedicationRequest.requester QDM matched to FHIR