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

## 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="example"/>
	<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="FLUVAX"/>
		</coding>
		<text value="Fluvax"/>
	</vaccineCode>
	<administeredProduct>
		<concept>
			<coding>
				<system value="urn:oid:2.16.840.1.113883.6.69"/>
				<code value="70461-0321-03"/>
			</coding>
			<text value="Flucelvax	(Influenza, injectable, MDCK, preservative free, quadrivalent)"/>
		</concept>
	</administeredProduct>
	<manufacturer>
		<reference>
			<reference value="Organization/hl7"/>
		</reference>
	</manufacturer>
	<lotNumber value="AAJN11K"/>
	<expirationDate value="2015-02-15"/>
	<patient>
		<reference value="Patient/example"/>
	</patient>
	<encounter>
		<reference value="Encounter/example"/>
	</encounter>
	<occurrenceDateTime value="2013-01-10"/>
	<primarySource value="true"/>
	<location>
		<reference value="Location/1"/>
	</location>
	<site>
		<coding>
			<system value="http://terminology.hl7.org/CodeSystem/v3-ActSite"/>
			<code value="LA"/>
			<display value="left arm"/>
		</coding>
	</site>
	<route>
		<coding>
			<system value="http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration"/>
			<code value="IM"/>
			<display value="Injection, intramuscular"/>
		</coding>
	</route>
	<doseQuantity>
		<value value="5"/>
		<system value="http://unitsofmeasure.org"/>
		<code value="mg"/>
	</doseQuantity>
	<performer>
		<function>
			<coding>
				<system value="http://terminology.hl7.org/CodeSystem/v2-0443"/>
				<code value="OP"/>
			</coding>
		</function>
    	<actor>
     		<reference value="Practitioner/example"/>
    	</actor>
	</performer>
	<performer>
		<function>
			<coding>
				<system value="http://terminology.hl7.org/CodeSystem/v2-0443"/>
				<code value="AP"/>
			</coding>
		</function>
    	<actor>
     		<reference value="Practitioner/example"/>
    	</actor>
	</performer>
	<note>
		<text value="Notes on adminstration of vaccine"/>
	</note>
	<reason>
    <concept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="429060002"/>
      </coding>
    </concept>
	</reason>
	<isSubpotent value="true"/>
	<programEligibility>
		<program>
			<text value="VFC"/>
		</program>
		<programStatus>
			<coding>
				<system value="http://terminology.hl7.org/CodeSystem/immunization-program-eligibility"/>
				<code value="uninsured"/>
			</coding>
		</programStatus>
	</programEligibility>
	<fundingSource>
		<coding>
			<system value="http://terminology.hl7.org/CodeSystem/immunization-funding-source"/>
			<code value="private"/>
		</coding>
	</fundingSource>
</Immunization>
```