Data Elements for Reporting Vaccine Administration to Registries

The table below provides the list of data elements used to transmit vaccine administration information to the registry. The HL7 2.5.1 immunization implementation guide informed the list. [Each element is Required (R), Required if Exists (RE), Conditional (C), Optional (O).]

TRANSMIT STANDARD PATIENT IMMUNIZATION HISTORY REPORT
Concept Name R/RE/O
Patient Identifier Number RE
Assigning Authority RE
Patient Identifier Type Code RE
Patient Name RE
Mother’s Maiden Name RE
Date/Time of Birth RE
Sex RE
Patient Address RE
Phone RE
Multiple Birth Indicator RE
Birth Order RE
Entered by RE
Ordering Provider RE
Vaccine Event Information Source C (R – Vaccine is Completed or Partially Administered/O)
Entering Organization RE
Vaccine Type R
Date/time Vaccine Administered R
Dose Number in Series O
Number of Doses in Primary Immunization Series O
Vaccine Administered R
Vaccine Lot Number R
Vaccine Expiration Date R
Vaccine Manufacturer Name R
Dose – Administered Amount of Vaccine R
Administered Units (of Measure) C (R – administered amount NOT ‘999’/O)
Administering Provider R
Administered-at Location R
Completion Status RE
Route of Administration RE
Administration Site RE
VFC status R
VIS type and Date R
Adverse Reactions O
Vaccination Contraindications O
Vaccine Refusal O
Dose Number in Series O
Number of Doses in Primary Immunization Series O