ActiveMonitoringDay3Survey
type: Questionnaire
node role: treeRoot
id:
  v: ActiveMonitoringDay3Survey
text:
  status:
    v: extensions
  div: Generated Narrative: Questionnaire ActiveMonitoringDay3Survey Structure LinkID Text Cardinality Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> ActiveMonitoringDay3Survey Te Whatu Ora 3-day post Influenza/Covid-19 booster vaccination survey. Questionnaire https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/ActiveMonitoringDay3Survey#0.2.2 #xD; p01-Intro 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’ 0..1 display #xD; p02-Screening page 02. Screening 0..1 group #xD; p02-q01-VaccineType page 02 question 1. Please confirm the vaccine(s) that you or your dependent (e.g., child) received 3 days ago 1..1 choice Options: 5 options #xD; p02-q02-SideEffects page 02 question 2. We would like to confirm your answer to the invitation text message. Did you experience any side effects after vaccinatio…
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/variable
  value: Expression
    name:
      v: vaccineReceived
    language:
      v: text/fhirpath
    expression:
      v: %resource.item.where(linkId='p02-Screening').item.first().answer.valueCoding.display
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/variable
  value: Expression
    name:
      v: validVaccine
    language:
      v: text/fhirpath
    expression:
      v: %vaccineReceived = 'COVID-19 and flu vaccines at the same time' or %vaccineReceived = 'Only flu vaccine' or %vaccineReceived = 'Only COVID-19 vaccine'
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/variable
  value: Expression
    name:
      v: experiencedSideEffects
    language:
      v: text/fhirpath
    expression:
      v: %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'
url:
  v: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/ActiveMonitoringDay3Survey
identifier:
  use:
    v: official
  value:
    v: ActiveMonitoringDay3Survey
  period:
    start:
      v: 2023-07-19
identifier:
  use:
    v: temp
  period:
    end:
      v: 2023-07-19
version:
  v: 0.2.2
name:
  v: ActiveMonitoringDay3Survey
title:
  v: Post Vaccine Symptom Check day 3 survey
status:
  v: draft
subject type:
  v: Patient
date:
  v: 2023-08-23T22:13:19+00:00
publisher:
  v: Te Whatu Ora
contact:
  name:
    v: Te Whatu Ora
  telecom:
    system:
      v: url
    value:
      v: https://www.tewhatuora.govt.nz/
contact:
  name:
    v: Te Whatu Ora Integration Team
  telecom:
    system:
      v: email
    use:
      v: work
description:
  v: Te Whatu Ora 3-day post Influenza/Covid-19 booster vaccination survey.
use context:
  code:
    system:
      v: http://terminology.hl7.org/CodeSystem/usage-context-type
    code:
      v: workflow
    display:
      v: Workflow Setting
  value: CodeableConcept
    text:
      v: Vaccination Side Effect Questionnaire
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
    code:
      v: NZ
    display:
      v: New Zealand
purpose:
  v: Survey of side effects and overall experience of Influenza/COVID-19 Booster vaccination after 3 days.
code: http://snomed.info/id/293104008
  system:
    v: http://snomed.info/sct
  code:
    v: 293104008
  display:
    v: Vaccine adverse reaction
item:
  link id:
    v: p01-Intro
  prefix:
    v: page 01
  text:
    v: 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:
        v: http://hl7.org/fhir/StructureDefinition/rendering-xhtml
      value: string
        v: Kia ora 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. 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’ If you need any help completing your survey you can call 0800 855 066 for assistance.
  type:
    v: display
item:
  link id:
    v: p02-Screening
  prefix:
    v: page 02
  text:
    v: Screening
  type:
    v: group
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      value: CodeableConcept
    link id:
      v: p02-q01-VaccineType
    prefix:
      v: page 02 question 1
    text:
      v: Please confirm the vaccine(s) that you or your dependent (e.g., child) received 3 days ago
    type:
      v: choice
    required:
      v: true
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      value: CodeableConcept
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
      value: Expression
    link id:
      v: p02-q02-SideEffects
    prefix:
      v: page 02 question 2
    text:
      v: We would like to confirm your answer to the invitation text message. Did you experience any side effects after vaccination?
    type:
      v: choice
    required:
      v: true
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
  item:
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
      value: Expression
    link id:
      v: p02-q03-SideEffectsScreening
    prefix:
      v: page 02 question 3
    type:
      v: group
    item:
      extension:
        value: CodeableConcept
      link id:
        v: p02-q03.1-WhoReceived

system:
  v: http://hl7.org/fhir/questionnaire-item-control
code:
  v: drop-down
display:
  v: Drop down

v: Drop down

v: COVID-19 and flu vaccines at the same time

v: COVID-19 and flu vaccines at the same time

v: Only flu vaccine

v: Only flu vaccine

v: Only COVID-19 vaccine

v: Only COVID-19 vaccine

v: Other vaccine

v: Other vaccine

v: Was not vaccinated or do not recall

v: Was not vaccinated or do not recall

system:
  v: http://hl7.org/fhir/questionnaire-item-control
code:
  v: drop-down
display:
  v: Drop down

v: text/fhirpath

v: %validVaccine

v: Yes

v: Yes

v: No

v: No

v: Can't remember

v: Can't remember

v: text/fhirpath

v: %validVaccine and %experiencedSideEffects

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
  code:
    v: drop-down
  display:
    v: Drop down

v: page 02 question 3.1

v: Who received the vaccine?

v: choice

v: true

value: Coding
  code:
    v: Myself
  display:
    v: Myself

value: Coding
  code:
    v: My dependent/whānau member
  display:
    v: My dependent/whānau member

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p02-q03.2-WhereReceived
prefix:
  v: page 02 question 3.2
text:
  v: Where did you/they go to receive your/their vaccination?
type:
  v: choice
required:
  v: true
answer option:
  value: Coding
    code:
      v: Community vaccination centre
    display:
      v: Community vaccination centre
answer option:
  value: Coding
    code:
      v: General practice
    display:
      v: General practice
answer option:
  value: Coding
    code:
      v: Pharmacy
    display:
      v: Pharmacy
answer option:
  value: Coding
    code:
      v: Mobile vaccination unit
    display:
      v: Mobile vaccination unit
answer option:
  value: Coding
    code:
      v: Hospital or emergency room
    display:
      v: Hospital or emergency room
answer option:
  value: Coding
    code:
      v: Other
    display:
      v: Other

link id:
  v: p02-q03.3-Pregnant
prefix:
  v: page 02 question 3.3
text:
  v: Were you/they pregnant/Hapu at the time of your/their vaccination?
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
  value: Expression
    language:
      v: text/fhirpath
    expression:
      v: %validVaccine and %experiencedSideEffects
link id:
  v: p03-EarlyOnsetReactions
prefix:
  v: page 03
text:
  v: Early onset reactions
type:
  v: group
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p03-q01-SelectedSideEffects
  prefix:
    v: page 03 question 1
  text:
    v: Did you/they experience any of the following after vaccination? (choose all that apply)
  type:
    v: choice
  required:
    v: true
  repeats:
    v: true
  answer option:
    value: Coding
      code:
        v: Anaphylaxis
      display:
        v: Anaphylaxis
  answer option:
    value: Coding
      code:
        v: Syncope (fainting)
      display:
        v: Syncope (fainting)
  answer option:
    value: Coding
      code:
        v: Seizure/ convulsion
      display:
        v: Seizure/ convulsion
  answer option:
    value: Coding
      code:
        v: I don't know/ unsure
      display:
        v: I don't know/ unsure
  answer option:
    value: Coding
      code:
        v: None of the above
      display:
        v: None of the above
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p03-q02-AnaphylaxisDelay
  prefix:
    v: page 03 question 2
  text:
    v: How long after vaccination did anaphylaxis occur?
  type:
    v: choice
  enable when:
    question:
      v: p03-q01-SelectedSideEffects
    operator:
      v: =
    answer: Coding
      display:
        v: Anaphylaxis
  enable behavior:
    v: all
  required:
    v: true
  answer option:
    value: Coding
      code:
        v: 0-5 minutes
      display:
        v: 0-5 minutes
  answer option:
    value: Coding
      code:
        v: 6-10 minutes
      display:
        v: 6-10 minutes
  answer option:
    value: Coding
      code:
        v: 11-15 minutes
      display:
        v: 11-15 minutes
  answer option:
    value: Coding
      code:
        v: 16-20 minutes
      display:
        v: 16-20 minutes
  answer option:
    value: Coding
      code:
        v: 21+ minutes
      display:
        v: 21+ minutes
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p03-q03-SyncopeDelay
  prefix:
    v: page 03 question 3
  text:
    v: How long after vaccination did syncope occur?
  type:
    v: choice
  enable when:
    question:
      v: p03-q01-SelectedSideEffects
    operator:
      v: =
    answer: Coding
      display:
        v: Syncope (fainting)
  enable behavior:
    v: all
  required:
    v: true
  answer option:
    value: Coding
      code:
        v: 0-5 minutes
  answer option:
    value: Coding
      code:
        v: 6-10 minutes
      display:
        v: 6-10 minutes
  answer option:
    value: Coding
      code:
        v: 11-15 minutes
      display:
        v: 11-15 minutes
  answer option:
    value: Coding
      code:
        v: 16-20 minutes
      display:
        v: 16-20 minutes
  answer option:
    value: Coding
      code:
        v: 21+ minutes
      display:
        v: 21+ minutes
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p03-q04-SeizureDelay
  prefix:
    v: page 03 question 4
  text:
    v: How long after vaccination did the seizure/ convulsions occur?
  type:
    v: choice
  enable when:
    question:
      v: p03-q01-SelectedSideEffects
    operator:
      v: =
    answer: Coding
      display:
        v: Seizure/ convulsion
  enable behavior:
    v: all
  required:
    v: true
  answer option:
    value: Coding
      code:
        v: 0-5 minutes
  answer option:
    value: Coding
      code:
        v: 6-10 minutes

v: check-box

v: Check-box

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: 6-10 minutes

value: Coding
  code:
    v: 11-15 minutes
  display:
    v: 11-15 minutes

value: Coding
  code:
    v: 16-20 minutes
  display:
    v: 16-20 minutes

value: Coding
  code:
    v: 21+ minutes
  display:
    v: 21+ minutes

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p03-q05-SeizureComorbidity
prefix:
  v: page 03 question 5
text:
  v: Did seizure/ convulsions occur with:
type:
  v: choice
enable when:
  question:
    v: p03-q01-SelectedSideEffects
  operator:
    v: =
  answer: Coding
    display:
      v: Seizure/ convulsion
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Syncope (fainting)
    display:
      v: Syncope (fainting)
answer option:
  value: Coding
    code:
      v: Fever
    display:
      v: Fever
answer option:
  value: Coding
    code:
      v: Other
    display:
      v: Other
answer option:
  value: Coding
    code:
      v: I don't know
    display:
      v: I don't know

extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
  value: Expression
    language:
      v: text/fhirpath
    expression:
      v: %validVaccine and %experiencedSideEffects
link id:
  v: p04-Reactions
prefix:
  v: page 04
text:
  v: Reactions
type:
  v: group
item:
  link id:
    v: p04-q01-ReactionsIntro
  prefix:
    v: page 04 question 1
  text:
    v: 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:
        v: http://hl7.org/fhir/StructureDefinition/rendering-xhtml
      value: string
        v: Please choose all the reactions that you/they experienced. If yes, describe the reaction 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
  type:
    v: display
item:
  link id:
    v: p04-q02-InjectionSiteDisorder
  code: http://snomed.info/id/95376002
    system:
      v: http://snomed.info/sct
    code:
      v: 95376002
    display:
      v: Injection site disorder
  prefix:
    v: page 04 question 2
  text:
    v: Injection site reaction (pain, redness, swelling, or itching at or near the injection site)
  type:
    v: boolean
  required:
    v: true
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p04-q03-InjectionSiteSeverity
  prefix:
    v: page 04 question 3
  text:
    v: Injection site reaction severity
  type:
    v: choice
  enable when:
    question:
      v: p04-q02-InjectionSiteDisorder
    operator:
      v: =
    answer: boolean
      v: true
  enable behavior:
    v: all
  required:
    v: true
  answer option:
    value: Coding
      code:
        v: Minor
      display:
        v: Minor
  answer option:
    value: Coding
      code:
        v: Mild
      display:
        v: Mild
  answer option:
    value: Coding
      code:
        v: Moderate
      display:
        v: Moderate
  answer option:
    value: Coding
      code:
        v: Serious
      display:
        v: Serious
  answer option:
    value: Coding
      code:
        v: Severe
      display:
        v: Severe
item:
  link id:
    v: p04-q04-Fever
  code: http://snomed.info/id/386661006
    system:
      v: http://snomed.info/sct
    code:
      v: 386661006
    display:
      v: Fever or high temperature
  prefix:
    v: page 04 question 4
  text:
    v: Fever (a temperature of 38°C or higher)
  type:
    v: boolean
  required:
    v: true
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p04-q05-FeverSeverity
  prefix:
    v: page 04 question 5
  text:
    v: Temperature/fever severity
  type:
    v: choice
  enable when:
    question:
      v: p04-q04-Fever
    operator:
      v: =
    answer: boolean
      v: true
  enable behavior:
    v: all
  required:
    v: true
  answer option:
    value: Coding
      code:
        v: Minor
      display:
        v: Minor
  answer option:
    value: Coding
      code:
        v: Mild
      display:
        v: Mild
  answer option:
    value: Coding
      code:
        v: Moderate
      display:
        v: Moderate
  answer option:
    value: Coding
      code:
        v: Serious
      display:
        v: Serious
  answer option:
    value: Coding
      code:
        v: Severe
      display:
        v: Severe
item:
  link id:
    v: p04-q06-Swelling
  prefix:
    v: page 04 question 6
  text:
    v: Swelling of glands (i.e., lymph nodes)
  type:
    v: boolean
  required:
    v: true
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p04-q07-SwellingLocation
  prefix:
    v: page 04 question 7
  text:
    v: Where abouts did you experience swelling?
  type:
    v: choice
  enable when:
    question:
      v: p04-q06-Swelling
    operator:
      v: =
    answer: boolean

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: drop-down

v: Drop down

boolean
v: true

v: all

v: true

value: Coding
  code:
    v: Same arm as vaccination
  display:
    v: Same arm as vaccination

value: Coding
  code:
    v: Opposite arm to vaccination
  display:
    v: Opposite arm to vaccination

value: Coding
  code:
    v: Other
  display:
    v: Other

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q08-SwellingSeverity
prefix:
  v: page 04 question 8
text:
  v: Swelling of glands severity
type:
  v: choice
enable when:
  question:
    v: p04-q06-Swelling
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q09-Chills
code: http://snomed.info/id/274640006
  system:
    v: http://snomed.info/sct
  code:
    v: 274640006
  display:
    v: Chills, shivering or feeling cold
prefix:
  v: page 04 question 9
text:
  v: Chills, shivering, or cold sweats
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q10-ChillsSeverity
prefix:
  v: page 04 question 10
text:
  v: Chills/shivering/cold sweats severity
type:
  v: choice
enable when:
  question:
    v: p04-q09-Chills
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q11-Headaches
prefix:
  v: page 04 question 11
text:
  v: Headaches
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q12-HeadachesSeverity
prefix:
  v: page 04 question 12
text:
  v: Headache severity
type:
  v: choice
enable when:
  question:
    v: p04-q11-Headaches
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q13-Rash
prefix:
  v: page 04 question 13
text:
  v: Rash (not at the injection site)
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q14-RashSeverity
prefix:
  v: page 04 question 14
text:
  v: Rash severity
type:
  v: choice
enable when:
  question:
    v: p04-q13-Rash
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q15-AchesPains
prefix:
  v: page 04 question 15
text:
  v: Aches and pains
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q16-AchesPainsSeverity
prefix:
  v: page 04 question 16
text:
  v: Aches and pains severity
type:
  v: choice
enable when:
  question:
    v: p04-q15-AchesPains
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q17-DigestiveDisorder
code: http://snomed.info/id/53619000
  system:
    v: http://snomed.info/sct
  code:
    v: 53619000
  display:
    v: Disorder of digestive system
prefix:
  v: page 04 question 17
text:
  v: Stomach symptoms (nausea, vomiting, diarrhoea, abdominal pain or loss of appetite)
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q18-DigestiveDisorderSeverity
prefix:
  v: page 04 question 18
text:
  v: Stomach symptoms severity
type:
  v: choice
enable when:
  question:
    v: p04-q17-DigestiveDisorder
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q19-Fatigue
code: http://snomed.info/id/84229001
  system:
    v: http://snomed.info/sct
  code:
    v: 84229001
  display:
    v: Fatigue
prefix:
  v: page 04 question 19
text:
  v: Fatigue or tiredness
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q20-FatigueSeverity
prefix:
  v: page 04 question 20
text:
  v: Fatigue or tiredness severity
type:
  v: choice
enable when:
  question:
    v: p04-q19-Fatigue
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q21-ChestSymptoms
prefix:
  v: page 04 question 21
text:
  v: Chest symptoms (chest pain/heaviness/tightness or heart palpitations/pounding/racing)
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q22-ChestSymptomsSeverity
prefix:
  v: page 04 question 22
text:
  v: Chest symptoms severity
type:
  v: choice
enable when:
  question:
    v: p04-q21-ChestSymptoms
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q23-DifficultyBreathing
code: http://snomed.info/id/230145002
  system:
    v: http://snomed.info/sct
  code:
    v: 230145002
  display:
    v: Difficulty breathing
prefix:
  v: page 04 question 23
text:
  v: Difficulty breathing
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q24-DifficultyBreathingSeverity
prefix:
  v: page 04 question 24
text:
  v: Difficulty breathing severity
type:
  v: choice
enable when:
  question:
    v: p04-q23-DifficultyBreathing
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q25-Dizziness
prefix:
  v: page 04 question 25
text:
  v: Dizziness or feeling lightheaded
type:
  v: boolean
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p04-q26-DizzinessSeverity
prefix:
  v: page 04 question 26
text:
  v: Dizziness or lightheaded severity
type:
  v: choice
enable when:
  question:
    v: p04-q25-Dizziness
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true
answer option:
  value: Coding
    code:
      v: Minor
    display:
      v: Minor
answer option:
  value: Coding
    code:
      v: Mild
    display:
      v: Mild
answer option:
  value: Coding
    code:
      v: Moderate
    display:
      v: Moderate
answer option:
  value: Coding
    code:
      v: Serious
    display:
      v: Serious
answer option:
  value: Coding
    code:
      v: Severe
    display:
      v: Severe

link id:
  v: p04-q27-OtherSymptoms
prefix:
  v: page 04 question 27
text:
  v: Did you/they experience any symptoms that were not listed above?
type:
  v: boolean
required:
  v: true

link id:
  v: p04-q28-OtherSymptomsDetail
prefix:
  v: page 04 question 28
text:
  v: Please explain
type:
  v: string
enable when:
  question:
    v: p04-q27-OtherSymptoms
  operator:
    v: =
  answer: boolean
    v: true
enable behavior:
  v: all
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
  value: Expression
    language:
      v: text/fhirpath
    expression:
      v: %validVaccine and %experiencedSideEffects
link id:
  v: p05-DailyImpact
prefix:
  v: page 05
text:
  v: Impact on daily activities
type:
  v: group
item:
  link id:
    v: p05-q01-MissedWork
  prefix:
    v: page 05 question 1
  text:
    v: Did any of the symptoms that you/they reported cause you/them to miss work, study, or normal daily activities?
  type:
    v: boolean
  required:
    v: true
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p05-q02-MissedWorkDetail
  prefix:
    v: page 05 question 2
  text:
    v: How many days did you miss?
  type:
    v: choice
  enable when:
    question:
      v: p05-q01-MissedWork
    operator:
      v: =
    answer: boolean
      v: true
  enable behavior:
    v: all
  required:
    v: true
  answer option:
    value: Coding
      code:
        v: Less than 1 day
      display:
        v: Less than 1 day
  answer option:
    value: Coding
      code:
        v: 1 day
      display:
        v: 1 day
  answer option:
    value: Coding
      code:
        v: 2 days
      display:
        v: 2 days
  answer option:
    value: Coding
      code:
        v: 3 or more days
      display:
        v: 3 or more days

v: drop-down

v: Drop down

extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
  value: Expression
    language:
      v: text/fhirpath
    expression:
      v: %validVaccine and %experiencedSideEffects
link id:
  v: p06-CareSought
prefix:
  v: page 06
text:
  v: Medical advice/care sought
type:
  v: group
item:
  link id:
    v: p06-q01-SymptomRelief
  prefix:
    v: page 06 question 1
  text:
    v: Did any of the symptoms cause you/them to seek advice or care from a healthcare professional?
  type:
    v: boolean
  required:
    v: true
item:
  link id:
    v: p06-q02-SymptomReliefDetail
  prefix:
    v: page 06 question 2
  text:
    v: Please choose the type of advice or care you/they sought. Please choose all that apply
  type:
    v: choice
  enable when:
    question:
      v: p06-q01-SymptomRelief
    operator:
      v: =
    answer: boolean
      v: true
  enable behavior:
    v: all
  required:
    v: true
  repeats:
    v: true
  answer option:
    value: Coding
      code:
        v: Phone advice from a helpline e.g., Healthline
      display:
        v: Phone advice from a helpline (e.g., Healthline)
  answer option:
    value: Coding
      code:
        v: Care from a GP clinic including the clinic nurse, a doctor, or a phone call with a person at the GP clinic.
      display:
        v: Care from a GP clinic (including the clinic nurse, a doctor, or a phone call with a person at the GP clinic).
  answer option:
    value: Coding
      code:
        v: Visit to a hospital emergency department
      display:
        v: Visit to a hospital emergency department
  answer option:
    value: Coding
      code:
        v: Māori Health Provider
      display:
        v: Māori Health Provider
  answer option:
    value: Coding
      code:
        v: Rongoā clinic
      display:
        v: Rongoā clinic
  answer option:
    value: Coding
      code:
        v: Whānau Ora navigator
      display:
        v: Whānau Ora navigator
  answer option:
    value: Coding
      code:
        v: Pharmacy
      display:
        v: Pharmacy
  answer option:
    value: Coding
      code:
        v: Other
      display:
        v: Other

extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
  value: Expression
    language:
      v: text/fhirpath
    expression:
      v: %validVaccine
link id:
  v: p07-VaccinationExperience
prefix:
  v: page 07
text:
  v: Vaccination experience
type:
  v: group
item:
  link id:
    v: p07-q01-OverallExperience
  prefix:
    v: page 07 question 1
  text:
    v: 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:
        v: http://hl7.org/fhir/StructureDefinition/rendering-xhtml
      value: string
        v: 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.
  type:
    v: choice
  required:
    v: true
  answer option:
    value: Coding
      code:
        v: Very poor
      display:
        v: Very poor
  answer option:
    value: Coding
      code:
        v: Poor
      display:
        v: Poor
  answer option:
    value: Coding
      code:
        v: Average
      display:
        v: Average
  answer option:
    value: Coding
      code:
        v: Good
      display:
        v: Good
  answer option:
    value: Coding
      code:
        v: Excellent
      display:
        v: Excellent
item:
  link id:
    v: p07-q02-Comments
  prefix:
    v: page 07 question 2
  text:
    v: Do you/they have any comments about your/their vaccine experience?
  type:
    v: boolean
  required:
    v: true
item:
  link id:
    v: p07-q03-CommentsDetail
  prefix:
    v: page 07 question 3
  text:
    v: Please explain
  type:
    v: text
  enable when:
    question:
      v: p07-q02-Comments
    operator:
      v: =
    answer: boolean
      v: true
  enable behavior:
    v: all
  required:
    v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      code:
        v: post-submit
link id:
  v: p08-Thanks
prefix:
  v: page 08
text:
  v: 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:
      v: http://hl7.org/fhir/StructureDefinition/rendering-xhtml
    value: string
      v: 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. Ngā mihi Health New Zealand
type:
  v: display