| Package | smart.who.int.icvp |
| Resource Type | Questionnaire |
| Id | pPreQual |
| FHIR Version | R4 |
| Source | http://smart.who.int/icvp/https://build.fhir.org/ig/WorldHealthOrganization/smart-icvp/Questionnaire-pPreQual.html |
| URL | http://smart.who.int/icvp/Questionnaire/pPreQual |
| Version | 0.1.0 |
| Status | draft |
| Date | 2025-07-15T19:22:42+00:00 |
| Authority | who |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire pPreQual
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  | Questionnaire | http://smart.who.int/icvp/Questionnaire/pPreQual#0.1.0 | ||
  name | Full Name of the client | 1..1 | string | |
 dob | Date of Birth | 1..1 | date | |
 sex | Sex | 0..1 | choice | Value Set: hl7VS-administrativeSex |
| nationality | Nationality | 0..1 | choice | Value Set: Country |
| nid | National Identification Document | 0..1 | string | |
 guardian | Parent or Guardian Details | 0..1 | group | |
  guardianName | Name of Parent or Guardian | 0..1 | string | |
| vaccineDetails | Vaccine Certificate Details | 1..* | group | |
| productID | Vaccine or Prophylaxis ID | 1..1 | choice | Value Set: http://smart.who.int/pcmt-vaxprequal/ValueSet/PreQualProductIDs |
| date | Date of Vaccination | 1..1 | date | |
| clinicianName | Name of supervising clinician | 0..1 | string | |
| issuer | Relevant authoring reponsible for issuing the certificate, or for overseeing the administration center | 0..1 | string | |
| batchNo.text | Batch Number | 1..1 | string | |
| validityPeriod | Certificate Validity Period | 0..1 | group | |
 startDate | From | 0..1 | date | |
| endDate | To | 0..1 | date | |
 attachment | Upload Paper Form image or PDF | 0..1 | attachment | |
| Documentation for this format | ||||
ValueSet #v3-Country
Language: en
FHIRurn:iso:std:iso:3166 where code matches (by regex) [A-Z]{3}ValueSet #ICVPProductIds
http://smart.who.int/pcmt-vaxprequal/CodeSystem/PreQualProductIDs| Code | Display |
| YellowFeverProductd2c75a15ed309658b3968519ddb31690 | 26/03/2009Yellow Fevern/aAmpoule2Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation |
| YellowFeverProduct771d1a5c0acaee3e2dc9d56af1aba49d | 26/03/2009Yellow Fevern/aAmpoule5Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation |
| YellowFeverProducte929626497bdbb71adbe925f0c09c79f | 26/03/2009Yellow Fevern/aAmpoule10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation |
| YellowFeverProduct01a3b83cf13e87948437db11cf5c34eb | 14/10/2022Yellow FeverSinSaVac™Vial10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation |
| YellowFeverProductf82b015dfb3b1feeacd4c44d95b3b3ec | 20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule5Institut Pasteur de DakarMinistère de la Santé publique |
| YellowFeverProduct223330a7c15da86b21cc363f591de002 | 20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule10Institut Pasteur de DakarMinistère de la Santé publique |
| YellowFeverProductffea8448252ee58b7a92add05f0c3431 | 20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule20Institut Pasteur de DakarMinistère de la Santé publique |
| YellowFeverProductd8a09f80301dc05e124f99ffe7711fc0 | 01/01/1987Yellow FeverSTAMARILVial + Ampoule10Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé |
| YellowFeverProductab01f006f8b24113f4a28cb50bfe6d9d | 17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)5Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria |
| YellowFeverProduct5f0639d8e4d52afef089aa7148c5060c | 10/12/2007Yellow FeverYellow FeverTwo vial set (active + excipient)10Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria |
| YellowFeverProducte0534dbc71a6cc09f56dce25216c538c | 17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)50Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria |
{
"resourceType": "Questionnaire",
"id": "pPreQual",
"meta": {
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"contained": [
{
"resourceType": "ValueSet",
"id": "v3-Country",
"language": "en",
"text": {
"status": "generated",
"div": "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet v3-Country</b></p><a name=\"v3-Country\"> </a><a name=\"hcv3-Country\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p></div><ul><li>Include codes from<a href=\"CodeSystem-ISO3166Part1.html\"><code>urn:iso:std:iso:3166</code></a> where code matches (by regex) [A-Z]{3}</li></ul></div>"
},
"url": "http://terminology.hl7.org/ValueSet/v3-Country",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.1.11.171"
}
],
"version": "3.0.0",
"name": "Country",
"title": "Country",
"status": "active",
"experimental": false,
"date": "2014-03-26",
"publisher": "Health Level Seven International",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://hl7.org"
},
{
"system": "email",
"value": "hq@HL7.org"
}
]
}
],
"description": "Countries of the world. ISO 3166, part 1, alpha-3 set.",
"copyright": "This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html",
"compose": {
"include": [
{
"system": "urn:iso:std:iso:3166",
"filter": [
{
"property": "code",
"op": "regex",
"value": "[A-Z]{3}"
}
]
}
]
}
},
{
"resourceType": "ValueSet",
"id": "ICVPProductIds",
"url": "http://smart.who.int/icvp/ValueSet/ICVPProductIds",
"name": "ICVPProductIds",
"title": "WHO ICVP Vaccine Product Ids",
"status": "active",
"experimental": true,
"description": "WHO ICVP Vaccine Product Ids",
"compose": {
"include": [
{
"system": "http://smart.who.int/pcmt-vaxprequal/CodeSystem/PreQualProductIDs",
"concept": [
{
"code": "YellowFeverProductd2c75a15ed309658b3968519ddb31690",
"display": "26/03/2009Yellow Fevern/aAmpoule2Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation"
},
{
"code": "YellowFeverProduct771d1a5c0acaee3e2dc9d56af1aba49d",
"display": "26/03/2009Yellow Fevern/aAmpoule5Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation"
},
{
"code": "YellowFeverProducte929626497bdbb71adbe925f0c09c79f",
"display": "26/03/2009Yellow Fevern/aAmpoule10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation"
},
{
"code": "YellowFeverProduct01a3b83cf13e87948437db11cf5c34eb",
"display": "14/10/2022Yellow FeverSinSaVac™Vial10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation"
},
{
"code": "YellowFeverProductf82b015dfb3b1feeacd4c44d95b3b3ec",
"display": "20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule5Institut Pasteur de DakarMinistère de la Santé publique"
},
{
"code": "YellowFeverProduct223330a7c15da86b21cc363f591de002",
"display": "20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule10Institut Pasteur de DakarMinistère de la Santé publique"
},
{
"code": "YellowFeverProductffea8448252ee58b7a92add05f0c3431",
"display": "20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule20Institut Pasteur de DakarMinistère de la Santé publique"
},
{
"code": "YellowFeverProductd8a09f80301dc05e124f99ffe7711fc0",
"display": "01/01/1987Yellow FeverSTAMARILVial + Ampoule10Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé"
},
{
"code": "YellowFeverProductab01f006f8b24113f4a28cb50bfe6d9d",
"display": "17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)5Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria"
},
{
"code": "YellowFeverProduct5f0639d8e4d52afef089aa7148c5060c",
"display": "10/12/2007Yellow FeverYellow FeverTwo vial set (active + excipient)10Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria"
},
{
"code": "YellowFeverProducte0534dbc71a6cc09f56dce25216c538c",
"display": "17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)50Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria"
}
]
}
]
}
}
],
"url": "http://smart.who.int/icvp/Questionnaire/pPreQual",
"version": "0.1.0",
"status": "draft",
"date": "2025-07-15T19:22:42+00:00",
"publisher": "WHO",
"contact": [
{
"name": "WHO",
"telecom": [
{
"system": "url",
"value": "http://who.int"
}
]
}
],
"item": [
{
"linkId": "name",
"text": "Full Name of the client",
"type": "string",
"required": true,
"repeats": false
},
{
"linkId": "dob",
"text": "Date of Birth",
"type": "date",
"required": true,
"repeats": false
},
{
"linkId": "sex",
"text": "Sex",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://terminology.hl7.org/ValueSet/v2-0001"
},
{
"linkId": "nationality",
"text": "Nationality",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://terminology.hl7.org/ValueSet/v3-Country"
},
{
"linkId": "nid",
"text": "National Identification Document",
"type": "string",
"required": false,
"repeats": false
},
{
"linkId": "guardian",
"text": "Parent or Guardian Details",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "guardianName",
"text": "Name of Parent or Guardian",
"type": "string",
"required": false,
"repeats": false
}
]
},
{
"linkId": "vaccineDetails",
"text": "Vaccine Certificate Details",
"type": "group",
"required": true,
"repeats": true,
"item": [
{
"linkId": "productID",
"text": "Vaccine or Prophylaxis ID",
"type": "choice",
"required": true,
"repeats": false,
"answerValueSet": "http://smart.who.int/pcmt-vaxprequal/ValueSet/PreQualProductIDs"
},
{
"linkId": "date",
"text": "Date of Vaccination",
"type": "date",
"required": true,
"repeats": false
},
{
"linkId": "clinicianName",
"text": "Name of supervising clinician",
"type": "string",
"required": false,
"repeats": false
},
{
"linkId": "issuer",
"text": "Relevant authoring reponsible for issuing the certificate, or for overseeing the administration center",
"type": "string",
"required": false,
"repeats": false
},
{
"linkId": "batchNo.text",
"text": "Batch Number",
"type": "string",
"required": true,
"repeats": false
},
{
"linkId": "validityPeriod",
"text": "Certificate Validity Period",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "startDate",
"text": "From",
"type": "date",
"required": false,
"repeats": false
},
{
"linkId": "endDate",
"text": "To",
"type": "date",
"required": false,
"repeats": false
}
]
}
]
},
{
"linkId": "attachment",
"text": "Upload Paper Form image or PDF",
"type": "attachment",
"required": false,
"repeats": false
}
]
}