Update ImmunizationRecomendation.targetDisease and ImmunizationEvaluation.targetDisease value sets to use SNOMED

[nathanbunker]

http://jira.hl7.org/browse/fhir-24959

Recommend targetDisease binding to SNOMED CT instead of CVX, additional constraint for ImmunizationRecommendation

1. ImmunizationRecomendation.targetDisease and ImmunizationEvaluation.targetDisease should be bound to SNOMED CT instead of CVX. CVX represents vaccines, not diseases.

Craig - For the first one, do we indicate that this is a US Realm IG and in the US, CVX is the vocabulary used for vaccine groups as a proxy for diseases? We should also keep in mind that while the binding is "extensible", the meaning of that is such that a non-CVX code cannot be use so long as CVX contains a code for that disease. We could extend the value set to include both CVX and SNOMED if we want.

I'm not sure the second one is correct. We were thinking that there would be scenarios where you might indicate the need for influenza but then contraindicate the live nasal vaccine for some reason. If we agree with this, we should also put the same constraint in the R5 base standard as there is nothing specific about the IG that requires this constraint.

Eric - I'm open to the first one if we think we should move to a different concept for disease - which I don't think would be a bad idea. The second comment is wrong in my opinion. Along with Craig's example, there is also a Rotavirus (I think) situation where a patient with an allergy to latex would be contraindicated against one Vaccine Product, but could receive the other Vaccine Product.

Proposed Disposition:

Suggestion #1: Persuasive, we will update the ImmunizationRecomendation.targetDisease and ImmunizationEvaluation.targetDisease value sets to use the list of SNOMED codes for vaccine preventable diseases currently captured in http://build.fhir.org/valueset-immunization-target-disease.html

[csnewman88]

New value set of SNOMED codes added and linked to both profiles