---
type: "example"
title: "Immunization Example: immunization-example-historical"
resource: "Immunization"
example: "immunization-example-historical"
---
# Immunization Example: immunization-example-historical

## Example XML



```xml
<?xml version="1.0" encoding="UTF-8"?>
<!--Authored by Joginder Madra-->
<Immunization xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/immunization.xsd">
	<id value="historical"/>
	<identifier>
		<system value="urn:ietf:rfc:3986"/>
		<value value="urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"/>
	</identifier>
	<status value="completed"/>
	<vaccineCode>
		<coding>
			<system value="urn:oid:1.2.36.1.2001.1005.17"/>
			<code value="GNFLU"/>
		</coding>
		<text value="Influenza"/>
	</vaccineCode>
	<patient>
		<reference value="Patient/example"/>
	</patient>
	<occurrenceString value="January 2012"/>
	<primarySource value="false"/>
	<informationSource>
		<concept>
			<coding>
				<system value="http://terminology.hl7.org/CodeSystem/immunization-origin"/>
				<code value="record"/>
			</coding>
			<text value="Written Record"/>
		</concept>
	</informationSource>
	<location>
		<reference value="Location/1"/>
	</location>
	<note>
		<text value="Notes on adminstration of a historical vaccine"/>
	</note>
</Immunization>
```