https://fhir-ig.digital.health.nz/shared-care/QuestionnaireResponse/ActiveMonitoringDay3SurveyQuestionnaireResponse
type: QuestionnaireResponse
node role: treeRoot
meta:
  version id:
    v: 1
  last updated:
    v: 2024-04-21T22:07:18.154Z
text:
  status:
    v: generated
  div: Generated Narrative: QuestionnaireResponse ActiveMonitoringDay3SurveyQuestionnaireResponse version: 1; Last updated: 2024-04-21 22:07:18+0000 LinkID Text Definition Answer<img src="[binary]" alt="doco" style="background-color: inherit"/> ActiveMonitoringDay3SurveyQuestionnaireResponse Questionnaire:Post Vaccine Symptom Check day 3 survey #xD; p01-Intro 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’ Immunization/452fb7d0-8d3d-4534-a147-25560206edc2 #xD; p02-Screening Screening #xD; p02-q01-VaccineType Please confirm the vaccine(s) that you or your dependent (e.g., child) received 3 days ago [not stated] Only flu vaccine: Only flu vaccine #xD; p02-q02-SideEffects We would like to confirm your answer to the invitation text message. Did you experience any side effects after vaccination? [not stated] Yes: Yes #xD; p02-q03-SideEffectsScreening #xD; p02-q03.1-Who…
questionnaire:
  v: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/ActiveMonitoringDay3Survey
  link: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/ActiveMonitoringDay3Survey
status:
  v: completed
subject:
  type:
    v: Patient
  identifier:
    use:
      v: official
    system:
      v: https://standards.digital.health.nz/ns/nhi-id
    value:
      v: ZJR6390
  display:
    v: No vaccine Curnow
authored:
  v: 2024-04-21T22:06:45.669Z
author:
  type:
    v: Patient
  identifier:
    use:
      v: official
    system:
      v: https://standards.digital.health.nz/ns/nhi-id
    value:
      v: ZJR6390
  display:
    v: No vaccine Curnow
item:
  link id:
    v: p01-Intro
  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’
  answer:
    value: string
item:
  link id:
    v: p02-Screening
  text:
    v: Screening
  item:
    link id:
      v: p02-q01-VaccineType
    text:
      v: Please confirm the vaccine(s) that you or your dependent (e.g., child) received 3 days ago
    answer:
      value: Coding
  item:
    link id:
      v: p02-q02-SideEffects
    text:
      v: We would like to confirm your answer to the invitation text message. Did you experience any side effects after vaccination?
    answer:
      value: Coding
  item:
    link id:
      v: p02-q03-SideEffectsScreening
    item:
      link id:
        v: p02-q03.1-WhoReceived
      text:
        v: Who received the vaccine?
      answer:
        value: Coding
    item:
      link id:
        v: p02-q03.2-WhereReceived
      text:
        v: Where did you/they go to receive your/their vaccination?
      answer:
        value: Coding
    item:
      link id:
        v: p02-q03.3-Pregnant
      text:
        v: Were you/they pregnant/Hapu at the time of your/their vaccination?
      answer:
        value: boolean
item:
  link id:
    v: p03-EarlyOnsetReactions
  text:
    v: Early onset reactions
  item:
    link id:
      v: p03-q01-SelectedSideEffects
    text:
      v: Did you/they experience any of the following after vaccination? (choose all that apply)
    answer:
      value: Coding
item:
  link id:
    v: p04-Reactions
  text:
    v: Reactions
  item:
    link id:
      v: p04-q01-ReactionsIntro
    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.
  item:
    link id:
      v: p04-q02-InjectionSiteDisorder
    text:
      v: Injection site reaction (pain, redness, swelling, or itching at or near the injection site)
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q04-Fever
    text:
      v: Fever (a temperature of 38°C or higher)
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q06-Swelling
    text:
      v: Swelling of glands (i.e., lymph nodes)
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q09-Chills
    text:
      v: Chills, shivering, or cold sweats
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q11-Headaches
    text:
      v: Headaches
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q13-Rash
    text:
      v: Rash (not at the injection site)
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q15-AchesPains
    text:
      v: Aches and pains
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q17-DigestiveDisorder
    text:
      v: Stomach symptoms (nausea, vomiting, diarrhoea, abdominal pain or loss of appetite)
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q19-Fatigue
    text:
      v: Fatigue or tiredness
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q21-ChestSymptoms
    text:
      v: Chest symptoms (chest pain/heaviness/tightness or heart palpitations/pounding/racing)
    answer:
      value: boolean
        v: false
  item:
    link id:
      v: p04-q23-DifficultyBreathing
    text:
      v: Difficulty breathing
    answer:
      value: boolean
        v: false

v: Only flu vaccine

v: Only flu vaccine

v: Yes

v: Yes

Coding
code:
  v: Myself
display:
  v: Myself

Coding
code:
  v: Community vaccination centre
display:
  v: Community vaccination centre

boolean
v: false

v: None of the above

v: None of the above

link id:
  v: p04-q25-Dizziness
text:
  v: Dizziness or feeling lightheaded
answer:
  value: boolean
    v: false

link id:
  v: p04-q27-OtherSymptoms
text:
  v: Did you/they experience any symptoms that were not listed above?
answer:
  value: boolean
    v: false

link id:
  v: p05-DailyImpact
text:
  v: Impact on daily activities
item:
  link id:
    v: p05-q01-MissedWork
  text:
    v: Did any of the symptoms that you/they reported cause you/them to miss work, study, or normal daily activities?
  answer:
    value: boolean
      v: true
item:
  link id:
    v: p05-q02-MissedWorkDetail
  text:
    v: How many days did you miss?
  answer:
    value: Coding
      code:
        v: Less than 1 day
      display:
        v: Less than 1 day

link id:
  v: p06-CareSought
text:
  v: Medical advice/care sought
item:
  link id:
    v: p06-q01-SymptomRelief
  text:
    v: Did any of the symptoms cause you/them to seek advice or care from a healthcare professional?
  answer:
    value: boolean
      v: true
item:
  link id:
    v: p06-q02-SymptomReliefDetail
  text:
    v: Please choose the type of advice or care you/they sought. Please choose all that apply
  answer:
    value: Coding
      code:
        v: Phone advice from a helpline e.g., Healthline
      display:
        v: Phone advice from a helpline (e.g., Healthline)
  answer:
    value: Coding
      code:
        v: Whānau Ora navigator
      display:
        v: Whānau Ora navigator

link id:
  v: p07-VaccinationExperience
text:
  v: Vaccination experience
item:
  link id:
    v: p07-q01-OverallExperience
  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.
  answer:
    value: Coding
      code:
        v: Average
      display:
        v: Average
item:
  link id:
    v: p07-q02-Comments
  text:
    v: Do you/they have any comments about your/their vaccine experience?
  answer:
    value: boolean
      v: true
item:
  link id:
    v: p07-q03-CommentsDetail
  text:
    v: Please explain
  answer:
    value: string
      v: ASsA

link id:
  v: p08-Thanks
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.