Contents

1 Series Display Selection
- 1.1 Selection Types
- 1.2 Inclusion or Exclusion of Series Display Selection and Number of Doses Remaining in Output
2 Number of Doses Remaining
3 Output Format Specifics
- 3.1 Series Selected for Display
- 3.2 Number of Doses Remaining
4 Sample Outputs

The Series Selection and Number of Doses Remaining feature is an optional feature that may be enabled by the ICE service provider. When the series_selection_display property is set in the ice.properties file, ICE will return, in the forecast of each vaccine group, the currently selected series and the number of doses remaining in that series.

The coded values described below are also listed on the ICE Implementation Guide Codes Google Sheet.

Note: This feature is under testing and is not yet available for general use.

Series Display Selection

In the recommendation for each vaccine group, a series may or may not be displayed. A series is typically not selected for display when the patient has already completed his/her series. When a series is selected for display, there are 3 different possible Series Selection Display Type designations:

Selection Types

SERIES_DISPLAY_UNAMBIGUOUS
- When this display type is specified, it indicates that there is no other series that could possibly be selected for the patient to complete a series for the vaccine group.
- ICE is forecasting the next dose based on this series. Therefore, the series specified by this display type can confidently be displayed/returned to the end user.
SERIES_DISPLAY_BEST_GUESS
- When this display type is specified, it indicates that while there is more than Series that could be used for the patient to complete a series in the vaccine group, the series specified is the “best guess” and the one that ICE is accurately using for the forecast.
- ICE is accurately forecasting the next dose based on this series. The series specified by this display type can confidently be displayed/returned to the end user, with the recognition that other series could potentially be followed or the series displayed by ICE may change future doses or vaccines added to the patient’s immunization record.
SERIES_DISPLAY_ALTERNATIVE (not currently used)
- Note: This is a placeholder feature and not currently used. Additional rules specific to each vaccine group need to be developed to accurately display alternatives. Please let us know if there is an interest in this feature.
- This display type may be returned by ICE when there are alternative series that could be followed to complete a series in the vaccine group. The utility of this display type has not yet been determined, so currently it is not returned in the ICE output.
- May or may not be returned in conjunction with a SERIES_DISPLAY_BEST_GUESS selection.
- An example utility for this display type would be when there are no shots on record for a particular vaccine group. For example, if a patient has not received any COVID-19 shots, ICE could return multiple different product-specific series.
- Unlike a series specified by SERIES_DISPLAY_UNAMBIGUOUS and SERIES_DISPLAY_BEST_GUESS, any series selection specified by this display type is not used by ICE when determining the forecast.

To summarize, whenever a Series is selected for display, the logic to determine which series is selected for display is as follows:

If there is only one series defined in a vaccine group, the series selection type is SERIES_DISPLAY_UNAMBIGUOUS.
If there is more than one series defined in a vaccine group, the series selection type is SERIES_DISPLAY_BEST_GUESS.
For purposes of the ICE service provider, a selection categorized as either SERIES_DISPLAY_UNAMBIGUOUS or SERIES_DISPLAY_BEST_GUESS may be returned to the end user.

Inclusion or Exclusion of Series Display Selection and Number of Doses Remaining in Output

The Series and Number of Doses Remaining structure is included (or excluded) from the output under the following circumstances.

For each vaccine group, the list of series are specified in the ICE wiki page.
If a dose is not recommended (i.e. - recommendation is CONDITIONAL or NOT_RECOMMENDED), a series display selection will not be returned in the output.
- The section will be excluded entirely from the ICE output.
If a dose is recommended (i.e. - recommendation is RECOMMENDED or FUTURE_RECOMMENDED) and the series is not complete, a series display selection will be returned in the output.
- The series display selection and the calculated number of doses remaining in the series will be output.
If a dose is recommended and the series is complete, a series display selection will be returned in the output.
- The series display selection is returned. The number of doses remaining will be set to “Recurring”.

Number of Doses Remaining

For each series display, the number of doses remaining is also returned in an embedded structure. The logic is as follows:

If the series is not complete and a dose is recommended (Due Now or Due in Future), the number of doses remaining is returned simply by subtracting the number of doses administered from the total number of doses needed to complete the selected series (i.e. - either SERIES_DISPLAY_UNAMBIGUOUS or SERIES_DISPLAY_BEST_GUESS)
If the series is complete, there are no recurring doses defined by the series, and no doses are recommended, the number of doses remaining is 0.
If the series is complete, there are no recurring series defined by the series, but a dose is nevertheless recommended by ICE (not a typical circumstance), the number of doses remaining is 0 doses remaining in series; one or more additional doses may still be recommended
If the series is complete, there are recurring doses defined by the series, and a dose is recommended, the number of doses remaining is Recurring.

Output Format Specifics

Series Selected for Display

Series Display Type: substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationFocus[@codeSystem = '2.16.840.1.113883.3.795.12.100.50']
Series Code Value: substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationValue[@codeSystem = '2.16.840.1.113883.3.795.12.100.10']

Number of Doses Remaining

The number of doses remaining is embedded under the selected series for display.

Number of Doses Remaining Code System: substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/relatedClinicalStatement/observationResult/observationFocus[@code = 'NUMBER_OF_DOSES_REMAINING' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']
Number of Doses Remaining Value (as text): substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/relatedClinicalStatement/observationResult/observationValue

Sample Outputs

Example 1 - DTP - 1 dose remaining to be administered in the 3-dose series

Example 2 - DTP - 3-dose series is complete; number of doses remaining is “Recurring”

Example 3 - Rotavirus - No Doses are Recommended; No applicable Series Information to Display

Example 4 - All Recommendations

The output below displays the forecast for every vaccine group and each of their series displays and doses remaining.

                <substanceAdministrationProposals>
                    <substanceAdministrationProposal>
                        <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/>
                        <id root="ed4a49df-3d00-40ce-a569-d24b84e96d0f"/>
                        <dataSourceType code="ICE_1.x-fb-doses-remaining.1-beta.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/>
                        <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/>
                        <substance>
                            <substanceCode code="600" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Varicella Vaccine Group"/>
                        </substance>
                        <proposedAdministrationTimeInterval high="20111128000000.000-0500" low="20110701000000.000-0400"/>
                        <validAdministrationTimeInterval low="20110701000000.000-0400"/>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="21068bf2-c810-4fe7-8840-8e9845d4ef58"/>
                                <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/>
                                <relatedClinicalStatement>
                                    <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                                    <observationResult>
                                        <id root="53815f6e-157d-43c8-a9d3-7b21248d2e4d"/>
                                        <observationFocus code="SERIES_DISPLAY_UNAMBIGUOUS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/>
                                        <observationValue>
                                            <concept code="Varicella2DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10"/>
                                        </observationValue>
                                        <relatedClinicalStatement>
                                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                                            <observationResult>
                                                <id root="91b04bca-8529-4447-9a78-094bc2e94a6a"/>
                                                <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/>
                                                <observationValue>
                                                    <text value="2"/>
                                                </observationValue>
                                            </observationResult>
                                        </relatedClinicalStatement>
                                    </observationResult>
                                </relatedClinicalStatement>
                            </observationResult>
                        </relatedClinicalStatement>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="30a44245-f557-4bae-9dff-6d0719a25901"/>
                                <observationFocus code="600" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Varicella Vaccine Group"/>
                                <observationValue>
                                    <concept code="RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Recommendation Status" displayName="Recommended"/>
                                </observationValue>
                                <interpretation code="DUE_NOW" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons" displayName="Due now."/>
                            </observationResult>
                        </relatedClinicalStatement>
                    </substanceAdministrationProposal>
                    <substanceAdministrationProposal>
                        <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/>
                        <id root="f582d188-ff13-4f1b-adc0-91a80430363a"/>
                        <dataSourceType code="ICE_1.x-fb-doses-remaining.1-beta.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/>
                        <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/>
                        <substance>
                            <substanceCode code="750" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Pneumococcal Vaccine Group"/>
                        </substance>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="f8823346-33eb-4fca-9b90-76431d8c0046"/>
                                <observationFocus code="750" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Pneumococcal Vaccine Group"/>
                                <observationValue>
                                    <concept code="CONDITIONAL" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Recommendation Status" displayName="Conditionally Recommended"/>
                                </observationValue>
                                <interpretation code="HIGH_RISK" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons" displayName="Recommended for high-risk groups."/>
                            </observationResult>
                        </relatedClinicalStatement>
                    </substanceAdministrationProposal>
                    <substanceAdministrationProposal>
                        <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/>
                        <id root="c0e34af1-ca4d-480b-8e6a-c9f369d147e5"/>
                        <dataSourceType code="ICE_1.x-fb-doses-remaining.1-beta.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/>
                        <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/>
                        <substance>
                            <substanceCode code="840" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="HPV Vaccine Group"/>
                        </substance>
                        <proposedAdministrationTimeInterval high="20230728000000.000-0400" low="20210701000000.000-0400"/>
                        <validAdministrationTimeInterval low="20190701000000.000-0400"/>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="8d5c4940-b1a3-4eca-b990-9dfaa1c1a6fe"/>
                                <observationFocus code="840" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="HPV Vaccine Group"/>
                                <observationValue>
                                    <concept code="FUTURE_RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Recommendation Status" displayName="Future Recommendation"/>
                                </observationValue>
                                <interpretation code="DUE_IN_FUTURE" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons" displayName="Due in the future."/>
                            </observationResult>
                        </relatedClinicalStatement>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="d11afba0-57b4-4088-bce3-e9ecc351cf75"/>
                                <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/>
                                <relatedClinicalStatement>
                                    <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                                    <observationResult>
                                        <id root="4345b621-2332-4c9e-83b6-f5e9da4cf3b6"/>
                                        <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/>
                                        <observationValue>
                                            <concept code="HPV2DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10"/>
                                        </observationValue>
                                        <relatedClinicalStatement>
                                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                                            <observationResult>
                                                <id root="bf33891d-9b52-41a9-93f7-bf06727429c3"/>
                                                <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/>
                                                <observationValue>
                                                    <text value="2"/>
                                                </observationValue>
                                            </observationResult>
                                        </relatedClinicalStatement>
                                    </observationResult>
                                </relatedClinicalStatement>
                            </observationResult>
                        </relatedClinicalStatement>
                    </substanceAdministrationProposal>
                    <substanceAdministrationProposal>
                        <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/>
                        <id root="89a025df-7872-46f2-9f05-de8dc0a28ab9"/>
                        <dataSourceType code="ICE_1.x-fb-doses-remaining.1-beta.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/>
                        <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/>
                        <substance>
                            <substanceCode code="835" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Meningococcal B Vaccine Group"/>
                        </substance>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="5c3972a0-723e-4ee9-9ddb-9409ad3eb94e"/>
                                <observationFocus code="835" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Meningococcal B Vaccine Group"/>
                                <observationValue>
                                    <concept code="NOT_RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Recommendation Status" displayName="Not Recommended"/>
                                </observationValue>
                                <interpretation code="BELOW_MINIMUM_AGE_HIGH_RISK_SERIES" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons" displayName="Below minimum age for this high risk series."/>
                            </observationResult>
                        </relatedClinicalStatement>
                    </substanceAdministrationProposal>
                    <substanceAdministrationProposal>
                        <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/>
                        <id root="59f566d3-e499-45ac-9db2-2d15dcbd9d21"/>
                        <dataSourceType code="ICE_1.x-fb-doses-remaining.1-beta.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/>
                        <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/>
                        <substance>
                            <substanceCode code="810" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Hep A Vaccine Group"/>
                        </substance>
                        <proposedAdministrationTimeInterval high="20120728000000.000-0400" low="20110701000000.000-0400"/>
                        <validAdministrationTimeInterval low="20110701000000.000-0400"/>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="8bdb36d9-781c-42a7-9857-c3d502c3f05a"/>
                                <observationFocus code="810" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Hep A Vaccine Group"/>
                                <observationValue>
                                    <concept code="RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Recommendation Status" displayName="Recommended"/>
                                </observationValue>
                                <interpretation code="DUE_NOW" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons" displayName="Due now."/>
                            </observationResult>
                        </relatedClinicalStatement>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="536bcd9e-df8c-40dd-9b98-8ac754d10ce9"/>
                                <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/>
                                <relatedClinicalStatement>
                                    <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                                    <observationResult>
                                        <id root="de467ce9-2ba5-4435-a531-f1ec195eacf1"/>
                                        <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/>
                                        <observationValue>
                                            <concept code="HepA2DoseChildAdultSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10"/>
                                        </observationValue>
                                        <relatedClinicalStatement>
                                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                                            <observationResult>
                                                <id root="1e2cb0df-41a0-4dcc-a1cd-e5fa618fa6b7"/>
                                                <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/>
                                                <observationValue>
                                                    <text value="2"/>
                                                </observationValue>
                                            </observationResult>
                                        </relatedClinicalStatement>
                                    </observationResult>
                                </relatedClinicalStatement>
                            </observationResult>
                        </relatedClinicalStatement>
                    </substanceAdministrationProposal>
                    <substanceAdministrationProposal>
                        <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/>
                        <id root="eebc09fb-4d18-4e88-8590-f69c0c5feeff"/>
                        <dataSourceType code="ICE_1.x-fb-doses-remaining.1-beta.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/>
                        <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/>
                        <substance>
                            <substanceCode code="187" codeSystem="2.16.840.1.113883.12.292" codeSystemName="Vaccines (CVX)" displayName="Zoster recombinant"/>
                        </substance>
                        <proposedAdministrationTimeInterval low="20600701000000.000-0400"/>
                        <validAdministrationTimeInterval low="20600701000000.000-0400"/>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="389e939b-0102-4270-875a-a69d3e78202b"/>
                                <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/>
                                <relatedClinicalStatement>
                                    <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                                    <observationResult>
                                        <id root="e8051d44-be64-4cd9-90a4-29eea84102d1"/>
                                        <observationFocus code="SERIES_DISPLAY_UNAMBIGUOUS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/>
                                        <observationValue>
                                            <concept code="ZosterSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10"/>
                                        </observationValue>
                                        <relatedClinicalStatement>
                                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                                            <observationResult>
                                                <id root="622507b6-bbc7-4fd6-ac88-6759a43de6fb"/>
                                                <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/>
                                                <observationValue>
                                                    <text value="2"/>
                                                </observationValue>
                                            </observationResult>
                                        </relatedClinicalStatement>
                                    </observationResult>
                                </relatedClinicalStatement>
                            </observationResult>
                        </relatedClinicalStatement>
                        <relatedClinicalStatement>
                            <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/>
                            <observationResult>
                                <id root="8f797500-688f-4e07-a7d7-928203835885"/>
                                <observationFocus code="620" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Zoster Vaccine Group"/>
                                <observationValue>
                                    <concept code="FUTURE_RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Recommendation Status" displayName="Future Recommendation"/>
                                </observationValue>
                                <interpretation code="DUE_IN_FUTURE" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons" displayName="Due in the future."/>
                            </observationResult>
                        </relatedClinicalStatement>
                    </substanceAdministrationProposal>
                    <substanceAdministrationProposal>
                        <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/>
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