Cities - Annual

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Attachment 10: Vaccine Data
Data Element Name

Data Element Description

Value Set Code

Vaccine administered product type

Indicates which product (vaccine) was administered

Vaccine administered date

Indicates the date that the vaccine was administered.

Vaccine dose number

Indicates the dose number in series

Vaccine product manufacturer

Indicates the company which manufactured the vaccine

PHVS_ManufacturersOfVa
ccinesMVX_CDC_NIP

Vaccine Lot Number
Vaccine Lot Expiration Date
Vaccine Event information source

Indicates the lot number for the vaccine administered
Indicates the expiry date for the vaccine administered
Indicates whether the vaccine was administered by the
provider organization recording the immunization or obtained
from a historical record
Identifies the schedule used for immunization evaluation and
forecast.
Indicates the reason the patient is either exempt from the
immunization or refuses the immunization

N/A
N/A

Immunization Schedule used
Exemption/refusal reason

National Drug Code (NDC)
Vaccination Record Identifier

NDC from the vaccine's bar code can be used to obtain
vaccine brand name and manufacturer.
Vaccination record identifier

PHVS_VaccinesAdminister
ed_VZ

N/A
N/A

PHVS_VaccineEventInform
ation Source_NND

N/A
N/A
N/A
N/A