Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.5 - release

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.5) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Example QuestionnaireResponse: ActiveMonitoringDay3SurveyQuestionnaireResponse

version: 1; Last updated: 2024-04-21 22:07:18+0000

LinkID | Text | Definition | Answer
--- | --- | --- | ---
ActiveMonitoringDay3SurveyQuestionnaireResponse |  |  | Questionnaire:Post Vaccine Symptom Check day 3 survey
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
p02-Screening | Screening |  |
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
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
p02-q03-SideEffectsScreening |  |  |
p02-q03.1-WhoReceived | Who received the vaccine? |  | [not stated] Myself: Myself
p02-q03.2-WhereReceived | Where did you/they go to receive your/their vaccination? |  | [not stated] Community vaccination centre: Community vaccination centre
p02-q03.3-Pregnant | Were you/they pregnant/Hapu at the time of your/their vaccination? |  | false
p03-EarlyOnsetReactions | Early onset reactions |  |
p03-q01-SelectedSideEffects | Did you/they experience any of the following after vaccination? (choose all that apply) |  | [not stated] None of the above: None of the above
p04-Reactions | Reactions |  |
p04-q01-ReactionsIntro | 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. |  |
p04-q02-InjectionSiteDisorder | Injection site reaction (pain, redness, swelling, or itching at or near the injection site) |  | false
p04-q04-Fever | Fever (a temperature of 38°C or higher) |  | false
p04-q06-Swelling | Swelling of glands (i.e., lymph nodes) |  | false
p04-q09-Chills | Chills, shivering, or cold sweats |  | false
p04-q11-Headaches | Headaches |  | false
p04-q13-Rash | Rash (not at the injection site) |  | false
p04-q15-AchesPains | Aches and pains |  | false
p04-q17-DigestiveDisorder | Stomach symptoms (nausea, vomiting, diarrhoea, abdominal pain or loss of appetite) |  | false
p04-q19-Fatigue | Fatigue or tiredness |  | false
p04-q21-ChestSymptoms | Chest symptoms (chest pain/heaviness/tightness or heart palpitations/pounding/racing) |  | false
p04-q23-DifficultyBreathing | Difficulty breathing |  | false
p04-q25-Dizziness | Dizziness or feeling lightheaded |  | false
p04-q27-OtherSymptoms | Did you/they experience any symptoms that were not listed above? |  | false
p05-DailyImpact | Impact on daily activities |  |
p05-q01-MissedWork | Did any of the symptoms that you/they reported cause you/them to miss work, study, or normal daily activities? |  | true
p05-q02-MissedWorkDetail | How many days did you miss? |  | [not stated] Less than 1 day: Less than 1 day
p06-CareSought | Medical advice/care sought |  |
p06-q01-SymptomRelief | Did any of the symptoms cause you/them to seek advice or care from a healthcare professional? |  | true
p06-q02-SymptomReliefDetail | Please choose the type of advice or care you/they sought. Please choose all that apply |  |
p07-VaccinationExperience | Vaccination experience |  |
p07-q01-OverallExperience | 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. |  | [not stated] Average: Average
p07-q02-Comments | Do you/they have any comments about your/their vaccine experience? |  | true
p07-q03-CommentsDetail | Please explain |  | ASsA
p08-Thanks | 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. |  |
Documentation for this format