Immunizations

Datasets

US Core 6.1.0 maps each USCDI data element onto a FHIR element.

Dataset	US Core 6.1.0 target profile(s)
`immunizations`	US Core Immunization

One row per administered (or refused) dose per patient. A member with three seasonal flu shots is three rows.

Column	Required	Format / values	Example
`record_id`	Yes	your stable key for this dose	`IM-0001`
`patient_identifier`	Yes	patient key	`MRN-4471903`
`status`	Yes	`completed`, `entered-in-error`, `not-done` immunization-status	`completed`
`status_reason_code`	If `not-done`	SNOMED CT or v3 ActReason code, with `status_reason_system` immunization-status-reason	`PATOBJ` patient objection
`vaccine_code`	Yes	CVX code, with `vaccine_system` (CVX assumed when empty) CVX Vaccines Administered Vaccine Set	`140` influenza, seasonal, injectable, preservative free
`occurrence_date`	Yes	datetime	`2025-10-02`
`performer_npi`	If available	10 digits, Luhn-valid over the `80840` prefix	`9999999995`
`primary_source`	Recommended	`true` / `false`	`true`
`is_deleted`	If retracting	`true` retracts this row	`true`

vaccine_code is the one coded field with no fallback: a row without it cannot become an Immunization. Send vaccine_system as http://hl7.org/fhir/sid/cvx. US Core requires the CVX coding, so a row sourced from a billed claim that only carries an NDC should send that NDC with vaccine_system as http://hl7.org/fhir/sid/ndc; Payerbox crosswalks it to CVX.
status marks each row: completed for a dose that was given, not-done for one that was not, entered-in-error to retract a record that should never have existed.
status_reason_code belongs only on not-done rows: why the vaccine was not given — patient objection, medical precaution, out of stock, immunity, or a SNOMED CT refusal code. Send status_reason_system as http://terminology.hl7.org/CodeSystem/v3-ActReason or http://snomed.info/sct.
occurrence_date is the administration date (for not-done rows, the date the dose was due or refused). A date without a time is fine.
performer_npi identifies the administering practitioner and must match a row in practitioners.
primary_source is true when the record comes from the party that administered the vaccine, false for secondhand reports — member-reported doses or history imported from another system.