Gather Immunization History
The Immunization resource is populated with vaccination data from multiple HIEBus sources, including medical and pharmacy claims, pharmacy fills, and patient history in electronic medical records. However some immunization-related medical claims may be stored as Procedures. To create as comprehensive an immunization history as possible, query both Immunization and Procedure.
Contents
Querying for All Immunizations
- Query Immunization by
/Immunization?patient=[PATIENT ID]. - Retrieve the CE Immunization
[VALUE SET URI]byhttps://[YOUR_FHIR_ENDPOINT]/ValueSet?version=CE-Immunization&name=Immunization. - Query Procedure by
/Procedure?patient=[PATIENT ID]&code:in=[VALUE SET URI].
Querying for Specific Immunizations
- Identify an individual code (See http://hl7.org/fhir/R4/valueset-vaccine-code) or retrieve a ValueSet for a fully-qualified URI.
- Query Immunization with
vaccine-code=[CODE]orvaccine-code:in=[VALUE SET URI]. - Query Procedure with
code=[CODE]orcode:in=[VALUE SET URI].
Querying for COVID-19 Vaccination
- Retrieve the COVID19
[VALUE SET URI]byhttps://[YOUR_FHIR_ENDPOINT]/ValueSet?version=COVID-19&name=COVID19%20Vaccinationand then query per above for specific immunizations.
Note
Be sure to use the fully-qualified URI for vaccine codes (such as
Be sure to use the fully-qualified URI for vaccine codes (such as
http://hl7.org/fhir/sid/cvx|135 for ‘Influenza, high dose seasonal’) or value sets (such as http://[domain].com/subsets/COVID-19/COVID19 Vaccination). For more information on value sets, review the Value Set Tutorial.
Real-World Data Considerations
- Date Administered - Can be found in
Immunization.occurrenceDateTimeandProcedure.performed. - Vaccine Codes
- Source data may be uncoded (description only) or coded in CVX, HCPCS/CPT, NDC, RxNorm, ICD-10-PCS, SNOMED, or a proprietary code system.
- HIEBus maps vaccine codes when possible to CVX which is published by the CDC https://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvx).
- When presenting immunization data, we recommend preferentially displaying the code listed with
userselected=falseandsystem=http://hl7.org/fhir/sid/cvxorsystem=http://www.nlm.nih.gov/research/umls/rxnormif available, while making the original source code (userselected=true) available to users in details.
Note
Results may contain multiple Immunization resources for the same vaccination event as source systems may send a record of the administration of the vaccine (e.g., HCPCS) and the vaccine itself (e.g., CVX, RxNorm). While HIEBus will de-duplicate data when possible (e.g. multiple encounters from the same EMR), there may be cases where we may not be able identify that data is duplicate (e.g., if HIEBus receives a pharmacy claim and an EMR encounter for the same immunization, or the same encounter received from an EMR and via a health information exchange without a common identifier).
Results may contain multiple Immunization resources for the same vaccination event as source systems may send a record of the administration of the vaccine (e.g., HCPCS) and the vaccine itself (e.g., CVX, RxNorm). While HIEBus will de-duplicate data when possible (e.g. multiple encounters from the same EMR), there may be cases where we may not be able identify that data is duplicate (e.g., if HIEBus receives a pharmacy claim and an EMR encounter for the same immunization, or the same encounter received from an EMR and via a health information exchange without a common identifier).
