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Source1

{
  "resourceType": "Immunization",
  "id": "SEIR-example-patient-refused",
  "meta": {
    "profile": [
      "http://build.fhir.org/ig/UP-Manila-SILab/immunizationfhirig/branches/master/StructureDefinition-seir-immunization.html"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "[URL_FOR_ADMINISTERED_PRODUCT_EXTENSION]",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "[PRODUCT_CODE]",
            "display": "Varicella-zoster live vaccine product"
          }
        ]
      }
    },
    {
      "url": "[URL_FOR_BATCH_NUMBER_EXTENSION]",
      "valueString": "BATCH-XYZ-789"
    },
    {
      "url": "http://example.org/fhir/StructureDefinition/patient-philhealth-id-on-immunization",
      "valueIdentifier": {
        "system": "http://www.philhealth.gov.ph/pin",
        "value": "JUANDC-PHILHEALTH-001"
      }
    },
    {
      "url": "http://example.org/fhir/StructureDefinition/patient-philsys-id-on-immunization",
      "valueIdentifier": {
        "system": "http://nationalidsystem.gov.ph/psn",
        "value": "JUANDC-PHILSYS-002"
      }
    },
    {
      "url": "http://example.org/fhir/StructureDefinition/mother-philhealth-id-on-immunization",
      "valueIdentifier": {
        "system": "http://www.philhealth.gov.ph/pin",
        "value": "MOTHERS-PHILHEALTH-12345"
      }
    },
    {
      "url": "http://example.org/fhir/StructureDefinition/mother-philsys-id-on-immunization",
      "valueIdentifier": {
        "system": "http://nationalidsystem.gov.ph/psn",
        "value": "MOTHERS-PHILSYS-67890"
      }
    }
  ],
  "status": "not-done",
  "statusReason": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "1620681000168106",
        "display": "Patient objection"
      }
    ],
    "text": "Patient refused immunization"
  },
  "vaccineCode": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "830851000168105",
        "display": "Varicella-zoster live vaccine"
      }
    ],
    "text": "Zostavax"
  },
  "patient": {
    "reference": "Patient/example1",
    "display": "Juan DELA CRUZ"
  },
  "encounter": {
    "reference": "Encounter/example-encounter",
    "display": "Outpatient Visit - June 14, 2024"
  },
  "occurrenceDateTime": "2024-06-14",
  "primarySource": true,
  "location": {
    "reference": "Location/example-vaccination-site",
    "display": "PGH Outpatient Clinic 3"
  },
  "lotNumber": "LotVZV987",
  "doseQuantity": {
    "value": 0.5,
    "unit": "mL",
    "system": "http://unitsofmeasure.org",
    "code": "mL"
  },
  "performer": [
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "AP",
            "display": "Administering Provider"
          }
        ],
        "text": "Administering Provider"
      },
      "actor": {
        "reference": "Practitioner/example0",
        "display": "Dr. Maria SANTOS"
      }
    },
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
            "code": "PRF",
            "display": "Performer"
          }
        ],
        "text": "Administering Organization"
      },
      "actor": {
        "reference": "Organization/example-facility",
        "display": "Philippine General Hospital"
      }
    }
  ],
  "note": [
    {
      "text": "Patient verbally refused the administration of the Varicella-zoster vaccine after counseling."
    }
  ]
}