{
  "resourceType": "Immunization",
  "id": "VAERSExampleImmunization",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/ibm-fda-icsr-immunization"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>AgeAtVaccination</b>: 12 years</p><p><b>status</b>: completed</p><p><b>vaccineCode</b>: <span title=\"Codes: {http://hl7.org/fhir/sid/ndc 7046101903}\">7046101903</span></p><p><b>patient</b>: <a href=\"Patient-VAERSPatient.html\">Generated Summary: id: 123456789; FNAME LNAME ; gender: male; birthDate: 1955-07-22</a></p><p><b>occurrence</b>: 2017-04-23</p><p><b>primarySource</b>: false</p></div>"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/ibm-fda-icsr-ext-ageatvaccination",
      "valueAge": {
        "value": 12,
        "unit": "years",
        "system": "http://unitsofmeasure.org",
        "code": "y"
      }
    }
  ],
  "status": "completed",
  "vaccineCode": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/sid/ndc",
        "code": "7046101903"
      }
    ]
  },
  "patient": {
    "reference": "Patient/VAERSPatient"
  },
  "occurrenceDateTime": "2017-04-23",
  "primarySource": false
}