Te Whatu Ora Shared Care FHIR API
0.3.9 - release
Te Whatu Ora Shared Care FHIR API
0.3.9 - release
Te Whatu Ora Shared Care FHIR API - Local Development build (v0.3.9) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft as of 2023-08-23 |
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="ActiveMonitoringDay3Survey"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description & Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> ActiveMonitoringDay3Survey</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Te Whatu Ora 3-day post Influenza/Covid-19 booster vaccination survey.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/ActiveMonitoringDay3Survey#0.2.2</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.p01-Intro" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Display" class="hierarchy"/> p01-Intro</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 01. This is the first of two surveys about your experience with receiving your vaccine. This survey will take approximately five minutes to complete. You will be asked about any reactions you had after your vaccination(s). If you did not have any there is also a section at the end for you to comment on any other parts of your vaccination experience. Your responses are important and will help contribute to the safety monitoring of vaccines in New Zealand. The information you provide is confidential and is protected by the Privacy Act 2020 and data security safeguards. Please remember this is a survey only, your answers will not result in a medical response to your situation. If you have any concerns about your health after your vaccination, call Healthline at 0800 611 116 or speak to your healthcare professional. If you experience any of the following symptoms, you should seek medical help urgently and tell them about your vaccinations: tightness, heaviness, discomfort, pressure or pain in your chest or neck difficulty breathing or catching your breath feeling faint, dizzy, or light-headed fluttering, racing, or pounding heart, or feeling like it’s ‘skipping beats’</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.p02-Screening" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> p02-Screening</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 02. Screening</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p02-q01-VaccineType" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p02-q01-VaccineType</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 02 question 1. Please confirm the vaccine(s) that you or your dependent (e.g., child) received 3 days ago</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.p02-q01-VaccineType">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p02-q02-SideEffects" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> p02-q02-SideEffects</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 02 question 2. We would like to confirm your answer to the invitation text message. Did you experience any side effects after vaccination?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.p02-q02-SideEffects">3 options</a><br/>Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-enableWhenExpression.html">Enable When</a>: <code>%validVaccine</code></li></ul></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck101.png)" id="item.p02-q03-SideEffectsScreening" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> p02-q03-SideEffectsScreening</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 02 question 3. null</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-enableWhenExpression.html">Enable When</a>: <code>%validVaccine and %experiencedSideEffects</code></li></ul></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)" id="item.p02-q03.1-WhoReceived" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> p02-q03.1-WhoReceived</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 02 question 3.1. Who received the vaccine?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.p02-q03.1-WhoReceived">2 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)" id="item.p02-q03.2-WhereReceived" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p02-q03.2-WhereReceived</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 02 question 3.2. Where did you/they go to receive your/their vaccination?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.p02-q03.2-WhereReceived">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1000.png)" id="item.p02-q03.3-Pregnant" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p02-q03.3-Pregnant</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 02 question 3.3. Were you/they pregnant/Hapu at the time of your/their vaccination?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.p03-EarlyOnsetReactions" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> p03-EarlyOnsetReactions</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 03. Early onset reactions</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-enableWhenExpression.html">Enable When</a>: <code>%validVaccine and %experiencedSideEffects</code></li></ul></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p03-q01-SelectedSideEffects" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> p03-q01-SelectedSideEffects</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 03 question 1. Did you/they experience any of the following after vaccination? (choose all that apply)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.p03-q01-SelectedSideEffects">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p03-q02-AnaphylaxisDelay" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p03-q02-AnaphylaxisDelay</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 03 question 2. How long after vaccination did anaphylaxis occur?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p03-q01-SelectedSideEffects">p03-q01-SelectedSideEffects</a> = Anaphylaxis</span><br/>Options: <a href="#opt-item.p03-q02-AnaphylaxisDelay">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p03-q03-SyncopeDelay" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> p03-q03-SyncopeDelay</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 03 question 3. How long after vaccination did syncope occur?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p03-q01-SelectedSideEffects">p03-q01-SelectedSideEffects</a> = Syncope (fainting)</span><br/>Options: <a href="#opt-item.p03-q03-SyncopeDelay">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p03-q04-SeizureDelay" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p03-q04-SeizureDelay</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 03 question 4. How long after vaccination did the seizure/ convulsions occur?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p03-q01-SelectedSideEffects">p03-q01-SelectedSideEffects</a> = Seizure/ convulsion</span><br/>Options: <a href="#opt-item.p03-q04-SeizureDelay">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.p03-q05-SeizureComorbidity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> p03-q05-SeizureComorbidity</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 03 question 5. Did seizure/ convulsions occur with:</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p03-q01-SelectedSideEffects">p03-q01-SelectedSideEffects</a> = Seizure/ convulsion</span><br/>Options: <a href="#opt-item.p03-q05-SeizureComorbidity">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.p04-Reactions" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> p04-Reactions</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04. Reactions</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-enableWhenExpression.html">Enable When</a>: <code>%validVaccine and %experiencedSideEffects</code></li></ul></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q01-ReactionsIntro" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: white; background-color: inherit" title="Display" class="hierarchy"/> p04-q01-ReactionsIntro</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 1. Please choose all the reactions that you/they experienced, and if yes describe, on a scale from Minor, Mild, Moderate, Serious, to Severe. For your rating take into account levels of pain, how long symptoms lasted and impact on daily life.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q02-InjectionSiteDisorder" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q02-InjectionSiteDisorder</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 2. Injection site reaction (pain, redness, swelling, or itching at or near the injection site)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q03-InjectionSiteSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> p04-q03-InjectionSiteSeverity</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 3. Injection site reaction severity</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q02-InjectionSiteDisorder">p04-q02-InjectionSiteDisorder</a> = true</span><br/>Options: <a href="#opt-item.p04-q03-InjectionSiteSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q04-Fever" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q04-Fever</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 4. Fever (a temperature of 38°C or higher)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q05-FeverSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> p04-q05-FeverSeverity</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 5. Temperature/fever severity</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q04-Fever">p04-q04-Fever</a> = true</span><br/>Options: <a href="#opt-item.p04-q05-FeverSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q06-Swelling" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q06-Swelling</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 6. Swelling of glands (i.e., lymph nodes)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q07-SwellingLocation" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> p04-q07-SwellingLocation</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 7. Where abouts did you experience swelling?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q06-Swelling">p04-q06-Swelling</a> = true</span><br/>Options: <a href="#opt-item.p04-q07-SwellingLocation">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q08-SwellingSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q08-SwellingSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 8. Swelling of glands severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q06-Swelling">p04-q06-Swelling</a> = true</span><br/>Options: <a href="#opt-item.p04-q08-SwellingSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q09-Chills" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q09-Chills</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 9. Chills, shivering, or cold sweats</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q10-ChillsSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q10-ChillsSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 10. Chills/shivering/cold sweats severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q09-Chills">p04-q09-Chills</a> = true</span><br/>Options: <a href="#opt-item.p04-q10-ChillsSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q11-Headaches" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q11-Headaches</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 11. Headaches</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q12-HeadachesSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q12-HeadachesSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 12. Headache severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q11-Headaches">p04-q11-Headaches</a> = true</span><br/>Options: <a href="#opt-item.p04-q12-HeadachesSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q13-Rash" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q13-Rash</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 13. Rash (not at the injection site)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q14-RashSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q14-RashSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 14. Rash severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q13-Rash">p04-q13-Rash</a> = true</span><br/>Options: <a href="#opt-item.p04-q14-RashSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q15-AchesPains" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q15-AchesPains</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 15. Aches and pains</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q16-AchesPainsSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q16-AchesPainsSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 16. Aches and pains severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q15-AchesPains">p04-q15-AchesPains</a> = true</span><br/>Options: <a href="#opt-item.p04-q16-AchesPainsSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q17-DigestiveDisorder" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q17-DigestiveDisorder</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 17. Stomach symptoms (nausea, vomiting, diarrhoea, abdominal pain or loss of appetite)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q18-DigestiveDisorderSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q18-DigestiveDisorderSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 18. Stomach symptoms severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q17-DigestiveDisorder">p04-q17-DigestiveDisorder</a> = true</span><br/>Options: <a href="#opt-item.p04-q18-DigestiveDisorderSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q19-Fatigue" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q19-Fatigue</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 19. Fatigue or tiredness</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q20-FatigueSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q20-FatigueSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 20. Fatigue or tiredness severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q19-Fatigue">p04-q19-Fatigue</a> = true</span><br/>Options: <a href="#opt-item.p04-q20-FatigueSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q21-ChestSymptoms" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q21-ChestSymptoms</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 21. Chest symptoms (chest pain/heaviness/tightness or heart palpitations/pounding/racing)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q22-ChestSymptomsSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q22-ChestSymptomsSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 22. Chest symptoms severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q21-ChestSymptoms">p04-q21-ChestSymptoms</a> = true</span><br/>Options: <a href="#opt-item.p04-q22-ChestSymptomsSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q23-DifficultyBreathing" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q23-DifficultyBreathing</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 23. Difficulty breathing</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q24-DifficultyBreathingSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q24-DifficultyBreathingSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 24. Difficulty breathing severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q23-DifficultyBreathing">p04-q23-DifficultyBreathing</a> = true</span><br/>Options: <a href="#opt-item.p04-q24-DifficultyBreathingSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q25-Dizziness" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q25-Dizziness</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 25. Dizziness or feeling lightheaded</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q26-DizzinessSeverity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p04-q26-DizzinessSeverity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 26. Dizziness or lightheaded severity</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q25-Dizziness">p04-q25-Dizziness</a> = true</span><br/>Options: <a href="#opt-item.p04-q26-DizzinessSeverity">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p04-q27-OtherSymptoms" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p04-q27-OtherSymptoms</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 27. Did you/they experience any symptoms that were not listed above?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.p04-q28-OtherSymptomsDetail" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="String" class="hierarchy"/> p04-q28-OtherSymptomsDetail</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 04 question 28. Please explain</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p04-q27-OtherSymptoms">p04-q27-OtherSymptoms</a> = true</span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.p05-DailyImpact" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> p05-DailyImpact</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 05. Impact on daily activities</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-enableWhenExpression.html">Enable When</a>: <code>%validVaccine and %experiencedSideEffects</code></li></ul></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p05-q01-MissedWork" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Boolean" class="hierarchy"/> p05-q01-MissedWork</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 05 question 1. Did any of the symptoms that you/they reported cause you/them to miss work, study, or normal daily activities?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.p05-q02-MissedWorkDetail" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> p05-q02-MissedWorkDetail</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 05 question 2. How many days did you miss?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p05-q01-MissedWork">p05-q01-MissedWork</a> = true</span><br/>Options: <a href="#opt-item.p05-q02-MissedWorkDetail">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.p06-CareSought" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> p06-CareSought</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 06. Medical advice/care sought</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-enableWhenExpression.html">Enable When</a>: <code>%validVaccine and %experiencedSideEffects</code></li></ul></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p06-q01-SymptomRelief" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p06-q01-SymptomRelief</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 06 question 1. Did any of the symptoms cause you/them to seek advice or care from a healthcare professional?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.p06-q02-SymptomReliefDetail" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p06-q02-SymptomReliefDetail</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 06 question 2. Please choose the type of advice or care you/they sought. Please choose all that apply</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p06-q01-SymptomRelief">p06-q01-SymptomRelief</a> = true</span><br/>Options: <a href="#opt-item.p06-q02-SymptomReliefDetail">8 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.p07-VaccinationExperience" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> p07-VaccinationExperience</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 07. Vaccination experience</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-enableWhenExpression.html">Enable When</a>: <code>%validVaccine</code></li></ul></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p07-q01-OverallExperience" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> p07-q01-OverallExperience</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 07 question 1. How would you/they rate the overall experience at the vaccination site? For your rating take into account informed consent process, staff helpfulness, vaccination site cleanliness etc.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.p07-q01-OverallExperience">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.p07-q02-Comments" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> p07-q02-Comments</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 07 question 2. Do you/they have any comments about your/their vaccine experience?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.p07-q03-CommentsDetail" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Text" class="hierarchy"/> p07-q03-CommentsDetail</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 07 question 3. Please explain</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p07-q02-Comments">p07-q02-Comments</a> = true</span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.p08-Thanks" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: white; background-color: inherit" title="Display" class="hierarchy"/> p08-Thanks</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">page 08. Thank you for completing the Day 3 post vaccine survey, your answers have been submitted. You will receive your next survey 42 days after your vaccination. The data collected by these surveys will be made available online on the Health NZ website. Survey data provided online are not identifiable and individual responses are confidential.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item.p02-q01-VaccineType"> </a><p><b>Answer options for p02-q01-VaccineType </b></p><ul><li style="font-size: 11px">null#null ("COVID-19 and flu vaccines at the same time")</li><li style="font-size: 11px">null#null ("Only flu vaccine")</li><li style="font-size: 11px">null#null ("Only COVID-19 vaccine")</li><li style="font-size: 11px">null#null ("Other vaccine")</li><li style="font-size: 11px">null#null ("Was not vaccinated or do not recall")</li></ul><a name="opt-item.p02-q02-SideEffects"> </a><p><b>Answer options for p02-q02-SideEffects </b></p><ul><li style="font-size: 11px">null#null ("Yes")</li><li style="font-size: 11px">null#null ("No")</li><li style="font-size: 11px">null#null ("Can't remember")</li></ul><a name="opt-item.p02-q03.1-WhoReceived"> </a><p><b>Answer options for p02-q03.1-WhoReceived </b></p><ul><li style="font-size: 11px">null#null ("Myself")</li><li style="font-size: 11px">null#null ("My dependent/whānau member")</li></ul><a name="opt-item.p02-q03.2-WhereReceived"> </a><p><b>Answer options for p02-q03.2-WhereReceived </b></p><ul><li style="font-size: 11px">null#null ("Community vaccination centre")</li><li style="font-size: 11px">null#null ("General practice")</li><li style="font-size: 11px">null#null ("Pharmacy")</li><li style="font-size: 11px">null#null ("Mobile vaccination unit")</li><li style="font-size: 11px">null#null ("Hospital or emergency room")</li><li style="font-size: 11px">null#null ("Other")</li></ul><a name="opt-item.p03-q01-SelectedSideEffects"> </a><p><b>Answer options for p03-q01-SelectedSideEffects </b></p><ul><li style="font-size: 11px">null#null ("Anaphylaxis")</li><li style="font-size: 11px">null#null ("Syncope (fainting)")</li><li style="font-size: 11px">null#null ("Seizure/ convulsion")</li><li style="font-size: 11px">null#null ("I don't know/ unsure")</li><li style="font-size: 11px">null#null ("None of the above")</li></ul><a name="opt-item.p03-q02-AnaphylaxisDelay"> </a><p><b>Answer options for p03-q02-AnaphylaxisDelay </b></p><ul><li style="font-size: 11px">null#null ("0-5 minutes")</li><li style="font-size: 11px">null#null ("6-10 minutes")</li><li style="font-size: 11px">null#null ("11-15 minutes")</li><li style="font-size: 11px">null#null ("16-20 minutes")</li><li style="font-size: 11px">null#null ("21+ minutes")</li></ul><a name="opt-item.p03-q03-SyncopeDelay"> </a><p><b>Answer options for p03-q03-SyncopeDelay </b></p><ul><li style="font-size: 11px">null#null ("0-5 minutes")</li><li style="font-size: 11px">null#null ("6-10 minutes")</li><li style="font-size: 11px">null#null ("11-15 minutes")</li><li style="font-size: 11px">null#null ("16-20 minutes")</li><li style="font-size: 11px">null#null ("21+ minutes")</li></ul><a name="opt-item.p03-q04-SeizureDelay"> </a><p><b>Answer options for p03-q04-SeizureDelay </b></p><ul><li style="font-size: 11px">null#null ("0-5 minutes")</li><li style="font-size: 11px">null#null ("6-10 minutes")</li><li style="font-size: 11px">null#null ("11-15 minutes")</li><li style="font-size: 11px">null#null ("16-20 minutes")</li><li style="font-size: 11px">null#null ("21+ minutes")</li></ul><a name="opt-item.p03-q05-SeizureComorbidity"> </a><p><b>Answer options for p03-q05-SeizureComorbidity </b></p><ul><li style="font-size: 11px">null#null ("Syncope (fainting)")</li><li style="font-size: 11px">null#null ("Fever")</li><li style="font-size: 11px">null#null ("Other")</li><li style="font-size: 11px">null#null ("I don't know")</li></ul><a name="opt-item.p04-q03-InjectionSiteSeverity"> </a><p><b>Answer options for p04-q03-InjectionSiteSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q05-FeverSeverity"> </a><p><b>Answer options for p04-q05-FeverSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q07-SwellingLocation"> </a><p><b>Answer options for p04-q07-SwellingLocation </b></p><ul><li style="font-size: 11px">null#null ("Same arm as vaccination")</li><li style="font-size: 11px">null#null ("Opposite arm to vaccination")</li><li style="font-size: 11px">null#null ("Other")</li></ul><a name="opt-item.p04-q08-SwellingSeverity"> </a><p><b>Answer options for p04-q08-SwellingSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q10-ChillsSeverity"> </a><p><b>Answer options for p04-q10-ChillsSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q12-HeadachesSeverity"> </a><p><b>Answer options for p04-q12-HeadachesSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q14-RashSeverity"> </a><p><b>Answer options for p04-q14-RashSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q16-AchesPainsSeverity"> </a><p><b>Answer options for p04-q16-AchesPainsSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q18-DigestiveDisorderSeverity"> </a><p><b>Answer options for p04-q18-DigestiveDisorderSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q20-FatigueSeverity"> </a><p><b>Answer options for p04-q20-FatigueSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q22-ChestSymptomsSeverity"> </a><p><b>Answer options for p04-q22-ChestSymptomsSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q24-DifficultyBreathingSeverity"> </a><p><b>Answer options for p04-q24-DifficultyBreathingSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p04-q26-DizzinessSeverity"> </a><p><b>Answer options for p04-q26-DizzinessSeverity </b></p><ul><li style="font-size: 11px">null#null ("Minor")</li><li style="font-size: 11px">null#null ("Mild")</li><li style="font-size: 11px">null#null ("Moderate")</li><li style="font-size: 11px">null#null ("Serious")</li><li style="font-size: 11px">null#null ("Severe")</li></ul><a name="opt-item.p05-q02-MissedWorkDetail"> </a><p><b>Answer options for p05-q02-MissedWorkDetail </b></p><ul><li style="font-size: 11px">null#null ("Less than 1 day")</li><li style="font-size: 11px">null#null ("1 day")</li><li style="font-size: 11px">null#null ("2 days")</li><li style="font-size: 11px">null#null ("3 or more days")</li></ul><a name="opt-item.p06-q02-SymptomReliefDetail"> </a><p><b>Answer options for p06-q02-SymptomReliefDetail </b></p><ul><li style="font-size: 11px">null#null ("Phone advice from a helpline (e.g., Healthline)")</li><li style="font-size: 11px">null#null ("Care from a GP clinic (including the clinic nurse, a doctor, or a phone call with a person at the GP clinic).")</li><li style="font-size: 11px">null#null ("Visit to a hospital emergency department")</li><li style="font-size: 11px">null#null ("Māori Health Provider")</li><li style="font-size: 11px">null#null ("Rongoā clinic")</li><li style="font-size: 11px">null#null ("Whānau Ora navigator")</li><li style="font-size: 11px">null#null ("Pharmacy")</li><li style="font-size: 11px">null#null ("Other")</li></ul><a name="opt-item.p07-q01-OverallExperience"> </a><p><b>Answer options for p07-q01-OverallExperience </b></p><ul><li style="font-size: 11px">null#null ("Very poor")</li><li style="font-size: 11px">null#null ("Poor")</li><li style="font-size: 11px">null#null ("Average")</li><li style="font-size: 11px">null#null ("Good")</li><li style="font-size: 11px">null#null ("Excellent")</li></ul></div>
</text>
<extension url="http://hl7.org/fhir/StructureDefinition/variable">
<valueExpression>
<name value="vaccineReceived"/>
<language value="text/fhirpath"/>
<expression
value="%resource.item.where(linkId='p02-Screening').item.first().answer.valueCoding.display"/>
</valueExpression>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/variable">
<valueExpression>
<name value="validVaccine"/>
<language value="text/fhirpath"/>
<expression
value="%vaccineReceived = 'COVID-19 and flu vaccines at the same time' or %vaccineReceived = 'Only flu vaccine' or %vaccineReceived = 'Only COVID-19 vaccine'"/>
</valueExpression>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/variable">
<valueExpression>
<name value="experiencedSideEffects"/>
<language value="text/fhirpath"/>
<expression
value="%resource.item.where(linkId='p02-Screening').item.where(linkId='p02-q02-SideEffects').answer.valueCoding.display = 'Yes' or %resource.item.where(linkId='p02-Screening').item.where(linkId='p02-q02-SideEffects').answer.valueCoding.display = 'Can\'t remember'"/>
</valueExpression>
</extension>
<url
value="https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/ActiveMonitoringDay3Survey"/>
<identifier>
<use value="official"/>
<value value="ActiveMonitoringDay3Survey"/>
<period>
<start value="2023-07-19"/>
</period>
</identifier>
<identifier>
<use value="temp"/>
<value value="Questionnaire-ActiveMonitoring-Day3SurveyQuestionnaire"/>
<period>
<end value="2023-07-19"/>
</period>
</identifier>
<version value="0.2.2"/>
<name value="ActiveMonitoringDay3Survey"/>
<title value="Post Vaccine Symptom Check day 3 survey"/>
<status value="draft"/>
<subjectType value="Patient"/>
<date value="2023-08-23T22:13:19+00:00"/>
<publisher value="Te Whatu Ora"/>
<contact>
<name value="Te Whatu Ora"/>
<telecom>
<system value="url"/>
<value value="https://www.tewhatuora.govt.nz/"/>
</telecom>
</contact>
<contact>
<name value="David Grainger"/>
<telecom>
<system value="email"/>
<value value="david.grainger@middleware.co.nz"/>
<use value="work"/>
</telecom>
</contact>
<description
value="Te Whatu Ora 3-day post Influenza/Covid-19 booster vaccination survey."/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="workflow"/>
<display value="Workflow Setting"/>
</code>
<valueCodeableConcept>
<text value="Vaccination Side Effect Questionnaire"/>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="NZ"/>
<display value="New Zealand"/>
</coding>
</jurisdiction>
<purpose
value="Survey of side effects and overall experience of Influenza/COVID-19 Booster vaccination after 3 days."/>
<code>
<system value="http://snomed.info/sct"/>
<code value="293104008"/>
<display value="Vaccine adverse reaction"/>
</code>
<item>
<linkId value="p01-Intro"/>
<prefix value="page 01"/>
<text
value="This is the first of two surveys about your experience with receiving your vaccine. This survey will take approximately five minutes to complete. You will be asked about any reactions you had after your vaccination(s). If you did not have any there is also a section at the end for you to comment on any other parts of your vaccination experience. Your responses are important and will help contribute to the safety monitoring of vaccines in New Zealand. The information you provide is confidential and is protected by the Privacy Act 2020 and data security safeguards. Please remember this is a survey only, your answers will not result in a medical response to your situation. If you have any concerns about your health after your vaccination, call Healthline at 0800 611 116 or speak to your healthcare professional. If you experience any of the following symptoms, you should seek medical help urgently and tell them about your vaccinations: tightness, heaviness, discomfort, pressure or pain in your chest or neck difficulty breathing or catching your breath feeling faint, dizzy, or light-headed fluttering, racing, or pounding heart, or feeling like it’s ‘skipping beats’">
<extension
url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString
value="<p>Kia ora</p><p>This is the first of two surveys about your experience with receiving your recent vaccination(s). This survey will take approximately five minutes to complete. You will be asked about any reactions you had after your vaccination(s). If you did not have any, there is also a section at the end for you to comment on any other parts of your vaccination experience. Your responses are important and will help contribute to the safety monitoring of vaccines in Aotearoa New Zealand. The information you provide is confidential and is protected by the Privacy Act 2020 and data security safeguards.</p><p>Please remember this is a survey only, your answers will not result in a medical response to your situation. If you have any concerns about your health after your vaccination, call Healthline at 0800 611 116 or speak to your healthcare professional.<p>If you experience any of the following symptoms, <u>you should seek medical help urgently</u> and tell them about your vaccinations: <ul><li>tightness, heaviness, discomfort, pressure or pain in your chest or neck</li><li>difficulty breathing or catching your breath</li><li>feeling faint, dizzy, or light-headed</li><li>fluttering, racing, or pounding heart, or feeling like it’s ‘skipping beats’</li></ul></p><p>If you need any help completing your survey you can call 0800 855 066 for assistance.</p>"/>
</extension>
</text>
<type value="display"/>
</item>
<item>
<linkId value="p02-Screening"/>
<prefix value="page 02"/>
<text value="Screening"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<linkId value="p02-q01-VaccineType"/>
<prefix value="page 02 question 1"/>
<text
value="Please confirm the vaccine(s) that you or your dependent (e.g., child) received 3 days ago"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="COVID-19 and flu vaccines at the same time"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Only flu vaccine"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Only COVID-19 vaccine"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Other vaccine"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Was not vaccinated or do not recall"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%validVaccine"/>
</valueExpression>
</extension>
<linkId value="p02-q02-SideEffects"/>
<prefix value="page 02 question 2"/>
<text
value="We would like to confirm your answer to the invitation text message. Did you experience any side effects after vaccination?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Yes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="No"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Can't remember"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%validVaccine and %experiencedSideEffects"/>
</valueExpression>
</extension>
<linkId value="p02-q03-SideEffectsScreening"/>
<prefix value="page 02 question 3"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p02-q03.1-WhoReceived"/>
<prefix value="page 02 question 3.1"/>
<text value="Who received the vaccine?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Myself"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="My dependent/whānau member"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p02-q03.2-WhereReceived"/>
<prefix value="page 02 question 3.2"/>
<text
value="Where did you/they go to receive your/their vaccination?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Community vaccination centre"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="General practice"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Pharmacy"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mobile vaccination unit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Hospital or emergency room"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Other"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p02-q03.3-Pregnant"/>
<prefix value="page 02 question 3.3"/>
<text
value="Were you/they pregnant/Hapu at the time of your/their vaccination?"/>
<type value="boolean"/>
<required value="true"/>
</item>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%validVaccine and %experiencedSideEffects"/>
</valueExpression>
</extension>
<linkId value="p03-EarlyOnsetReactions"/>
<prefix value="page 03"/>
<text value="Early onset reactions"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="check-box"/>
<display value="Check-box"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p03-q01-SelectedSideEffects"/>
<prefix value="page 03 question 1"/>
<text
value="Did you/they experience any of the following after vaccination? (choose all that apply)"/>
<type value="choice"/>
<required value="true"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<display value="Anaphylaxis"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Syncope (fainting)"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Seizure/ convulsion"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="I don't know/ unsure"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="None of the above"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p03-q02-AnaphylaxisDelay"/>
<prefix value="page 03 question 2"/>
<text value="How long after vaccination did anaphylaxis occur?"/>
<type value="choice"/>
<enableWhen>
<question value="p03-q01-SelectedSideEffects"/>
<operator value="="/>
<answerCoding>
<display value="Anaphylaxis"/>
</answerCoding>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="0-5 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="6-10 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="11-15 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="16-20 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="21+ minutes"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p03-q03-SyncopeDelay"/>
<prefix value="page 03 question 3"/>
<text value="How long after vaccination did syncope occur?"/>
<type value="choice"/>
<enableWhen>
<question value="p03-q01-SelectedSideEffects"/>
<operator value="="/>
<answerCoding>
<display value="Syncope (fainting)"/>
</answerCoding>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="0-5 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="6-10 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="11-15 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="16-20 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="21+ minutes"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p03-q04-SeizureDelay"/>
<prefix value="page 03 question 4"/>
<text
value="How long after vaccination did the seizure/ convulsions occur?"/>
<type value="choice"/>
<enableWhen>
<question value="p03-q01-SelectedSideEffects"/>
<operator value="="/>
<answerCoding>
<display value="Seizure/ convulsion"/>
</answerCoding>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="0-5 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="6-10 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="11-15 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="16-20 minutes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="21+ minutes"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p03-q05-SeizureComorbidity"/>
<prefix value="page 03 question 5"/>
<text value="Did seizure/ convulsions occur with:"/>
<type value="choice"/>
<enableWhen>
<question value="p03-q01-SelectedSideEffects"/>
<operator value="="/>
<answerCoding>
<display value="Seizure/ convulsion"/>
</answerCoding>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Syncope (fainting)"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Fever"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Other"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="I don't know"/>
</valueCoding>
</answerOption>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%validVaccine and %experiencedSideEffects"/>
</valueExpression>
</extension>
<linkId value="p04-Reactions"/>
<prefix value="page 04"/>
<text value="Reactions"/>
<type value="group"/>
<item>
<linkId value="p04-q01-ReactionsIntro"/>
<prefix value="page 04 question 1"/>
<text
value="Please choose all the reactions that you/they experienced, and if yes describe, on a scale from Minor, Mild, Moderate, Serious, to Severe. For your rating take into account levels of pain, how long symptoms lasted and impact on daily life.">
<extension
url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString
value="<p>Please choose all the reactions that you/they experienced. If yes, describe the reaction on a scale from minor, mild, moderate, serious, to severe.</p><p>For your rating take into account levels of pain, how long symptoms lasted and impact on daily life</p>"/>
</extension>
</text>
<type value="display"/>
</item>
<item>
<linkId value="p04-q02-InjectionSiteDisorder"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="95376002"/>
<display value="Injection site disorder"/>
</code>
<prefix value="page 04 question 2"/>
<text
value="Injection site reaction (pain, redness, swelling, or itching at or near the injection site)"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q03-InjectionSiteSeverity"/>
<prefix value="page 04 question 3"/>
<text value="Injection site reaction severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q02-InjectionSiteDisorder"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q04-Fever"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="386661006"/>
<display value="Fever or high temperature"/>
</code>
<prefix value="page 04 question 4"/>
<text value="Fever (a temperature of 38°C or higher)"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q05-FeverSeverity"/>
<prefix value="page 04 question 5"/>
<text value="Temperature/fever severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q04-Fever"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q06-Swelling"/>
<prefix value="page 04 question 6"/>
<text value="Swelling of glands (i.e., lymph nodes)"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q07-SwellingLocation"/>
<prefix value="page 04 question 7"/>
<text value="Where abouts did you experience swelling?"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q06-Swelling"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Same arm as vaccination"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Opposite arm to vaccination"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Other"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q08-SwellingSeverity"/>
<prefix value="page 04 question 8"/>
<text value="Swelling of glands severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q06-Swelling"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q09-Chills"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="274640006"/>
<display value="Chills, shivering or feeling cold"/>
</code>
<prefix value="page 04 question 9"/>
<text value="Chills, shivering, or cold sweats"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q10-ChillsSeverity"/>
<prefix value="page 04 question 10"/>
<text value="Chills/shivering/cold sweats severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q09-Chills"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q11-Headaches"/>
<prefix value="page 04 question 11"/>
<text value="Headaches"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q12-HeadachesSeverity"/>
<prefix value="page 04 question 12"/>
<text value="Headache severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q11-Headaches"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q13-Rash"/>
<prefix value="page 04 question 13"/>
<text value="Rash (not at the injection site)"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q14-RashSeverity"/>
<prefix value="page 04 question 14"/>
<text value="Rash severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q13-Rash"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q15-AchesPains"/>
<prefix value="page 04 question 15"/>
<text value="Aches and pains"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q16-AchesPainsSeverity"/>
<prefix value="page 04 question 16"/>
<text value="Aches and pains severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q15-AchesPains"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q17-DigestiveDisorder"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="53619000"/>
<display value="Disorder of digestive system"/>
</code>
<prefix value="page 04 question 17"/>
<text
value="Stomach symptoms (nausea, vomiting, diarrhoea, abdominal pain or loss of appetite)"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q18-DigestiveDisorderSeverity"/>
<prefix value="page 04 question 18"/>
<text value="Stomach symptoms severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q17-DigestiveDisorder"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q19-Fatigue"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="84229001"/>
<display value="Fatigue"/>
</code>
<prefix value="page 04 question 19"/>
<text value="Fatigue or tiredness"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q20-FatigueSeverity"/>
<prefix value="page 04 question 20"/>
<text value="Fatigue or tiredness severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q19-Fatigue"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q21-ChestSymptoms"/>
<prefix value="page 04 question 21"/>
<text
value="Chest symptoms (chest pain/heaviness/tightness or heart palpitations/pounding/racing)"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q22-ChestSymptomsSeverity"/>
<prefix value="page 04 question 22"/>
<text value="Chest symptoms severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q21-ChestSymptoms"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q23-DifficultyBreathing"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="230145002"/>
<display value="Difficulty breathing"/>
</code>
<prefix value="page 04 question 23"/>
<text value="Difficulty breathing"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q24-DifficultyBreathingSeverity"/>
<prefix value="page 04 question 24"/>
<text value="Difficulty breathing severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q23-DifficultyBreathing"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q25-Dizziness"/>
<prefix value="page 04 question 25"/>
<text value="Dizziness or feeling lightheaded"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p04-q26-DizzinessSeverity"/>
<prefix value="page 04 question 26"/>
<text value="Dizziness or lightheaded severity"/>
<type value="choice"/>
<enableWhen>
<question value="p04-q25-Dizziness"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Minor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Serious"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p04-q27-OtherSymptoms"/>
<prefix value="page 04 question 27"/>
<text
value="Did you/they experience any symptoms that were not listed above?"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<linkId value="p04-q28-OtherSymptomsDetail"/>
<prefix value="page 04 question 28"/>
<text value="Please explain"/>
<type value="string"/>
<enableWhen>
<question value="p04-q27-OtherSymptoms"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%validVaccine and %experiencedSideEffects"/>
</valueExpression>
</extension>
<linkId value="p05-DailyImpact"/>
<prefix value="page 05"/>
<text value="Impact on daily activities"/>
<type value="group"/>
<item>
<linkId value="p05-q01-MissedWork"/>
<prefix value="page 05 question 1"/>
<text
value="Did any of the symptoms that you/they reported cause you/them to miss work, study, or normal daily activities?"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p05-q02-MissedWorkDetail"/>
<prefix value="page 05 question 2"/>
<text value="How many days did you miss?"/>
<type value="choice"/>
<enableWhen>
<question value="p05-q01-MissedWork"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Less than 1 day"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="1 day"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="2 days"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="3 or more days"/>
</valueCoding>
</answerOption>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%validVaccine and %experiencedSideEffects"/>
</valueExpression>
</extension>
<linkId value="p06-CareSought"/>
<prefix value="page 06"/>
<text value="Medical advice/care sought"/>
<type value="group"/>
<item>
<linkId value="p06-q01-SymptomRelief"/>
<prefix value="page 06 question 1"/>
<text
value="Did any of the symptoms cause you/them to seek advice or care from a healthcare professional?"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<linkId value="p06-q02-SymptomReliefDetail"/>
<prefix value="page 06 question 2"/>
<text
value="Please choose the type of advice or care you/they sought. Please choose all that apply"/>
<type value="choice"/>
<enableWhen>
<question value="p06-q01-SymptomRelief"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<display value="Phone advice from a helpline (e.g., Healthline)"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display
value="Care from a GP clinic (including the clinic nurse, a doctor, or a phone call with a person at the GP clinic)."/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Visit to a hospital emergency department"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Māori Health Provider"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Rongoā clinic"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Whānau Ora navigator"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Pharmacy"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Other"/>
</valueCoding>
</answerOption>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%validVaccine"/>
</valueExpression>
</extension>
<linkId value="p07-VaccinationExperience"/>
<prefix value="page 07"/>
<text value="Vaccination experience"/>
<type value="group"/>
<item>
<linkId value="p07-q01-OverallExperience"/>
<prefix value="page 07 question 1"/>
<text
value="How would you/they rate the overall experience at the vaccination site? For your rating take into account informed consent process, staff helpfulness, vaccination site cleanliness etc.">
<extension
url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString
value="<p>How would you/they rate the overall experience at the vaccination site?</p><p>For your rating take into account informed consent process, staff helpfulness, vaccination site cleanliness, etc.</p>"/>
</extension>
</text>
<type value="choice"/>
<required value="true"/>
<answerOption>
<valueCoding>
<display value="Very poor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Poor"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Average"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Good"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<display value="Excellent"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p07-q02-Comments"/>
<prefix value="page 07 question 2"/>
<text
value="Do you/they have any comments about your/their vaccine experience?"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<linkId value="p07-q03-CommentsDetail"/>
<prefix value="page 07 question 3"/>
<text value="Please explain"/>
<type value="text"/>
<enableWhen>
<question value="p07-q02-Comments"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="all"/>
<required value="true"/>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<code value="post-submit"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="p08-Thanks"/>
<prefix value="page 08"/>
<text
value="Thank you for completing the Day 3 post vaccine survey, your answers have been submitted. You will receive your next survey 42 days after your vaccination. The data collected by these surveys will be made available online on the Health NZ website. Survey data provided online are not identifiable and individual responses are confidential.">
<extension
url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString
value="<p>Thank you for completing the Day 3 post vaccine survey, your answers have been submitted. You will receive your next survey 42 days after your vaccination. The data collected by these surveys will be made available online on the Health NZ website. Survey data provided online are not identifiable and individual responses are confidential.</p><p>Ngā mihi</p><p>Health New Zealand</p>"/>
</extension>
</text>
<type value="display"/>
</item>
</Questionnaire>