Health New Zealand Te Whatu Ora Shared Care FHIR API
1.4.8 - release
Health New Zealand Te Whatu Ora Shared Care FHIR API
1.4.8 - release
Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v1.4.8) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
<QuestionnaireResponse xmlns="http://hl7.org/fhir">
<meta>
<versionId value="1"/>
<lastUpdated value="2024-04-21T22:07:18.154Z"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: QuestionnaireResponse ActiveMonitoringDay3SurveyQuestionnaireResponse</b></p><a name="ActiveMonitoringDay3SurveyQuestionnaireResponse"> </a><a name="hcActiveMonitoringDay3SurveyQuestionnaireResponse"> </a><div style="display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1; Last updated: 2024-04-21 22:07:18+0000</p></div><table border="1" cellpadding="0" cellspacing="0" class="xhtTableBorder1"><tr class="xhtRowBorder2"><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Definition</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Answer</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="" style="background-color: white; background-color: inherit" title="QuestionnaireResponseRoot" class="hierarchy"/> ActiveMonitoringDay3SurveyQuestionnaireResponse</td><td style="" class="hierarchy xhtCellBorder1"></td><td style="" class="hierarchy xhtCellBorder1"></td><td style="" class="hierarchy xhtCellBorder1">Questionnaire:<a href="Questionnaire-ActiveMonitoringDay3Survey.html">Post Vaccine Symptom Check day 3 survey</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck10.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / </span>p01-Intro</td><td style="" class="hierarchy xhtCellBorder1">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’</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Immunization/452fb7d0-8d3d-4534-a147-25560206edc2</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck11.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / </span>p02-Screening</td><td style="" class="hierarchy xhtCellBorder1">Screening</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / </span>p02-q01-VaccineType</td><td style="" class="hierarchy xhtCellBorder1">Please confirm the vaccine(s) that you or your dependent (e.g., child) received 3 days ago</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"><span><span>[not stated]: Only flu vaccine (Only flu vaccine)</span></span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / </span>p02-q02-SideEffects</td><td style="" class="hierarchy xhtCellBorder1">We would like to confirm your answer to the invitation text message. Did you experience any side effects after vaccination?</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"><span><span>[not stated]: Yes (Yes)</span></span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck101.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / </span>p02-q03-SideEffectsScreening</td><td style="" class="hierarchy xhtCellBorder1"></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1010.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / p02-q03-SideEffectsScreening / </span>p02-q03.1-WhoReceived</td><td style="" class="hierarchy xhtCellBorder1">Who received the vaccine?</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"><span><span>[not stated]: Myself (Myself)</span></span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1010.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / p02-q03-SideEffectsScreening / </span>p02-q03.2-WhereReceived</td><td style="" class="hierarchy xhtCellBorder1">Where did you/they go to receive your/their vaccination?</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"><span><span>[not stated]: Community vaccination centre (Community vaccination centre)</span></span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1000.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / p02-q03-SideEffectsScreening / </span>p02-q03.3-Pregnant</td><td style="" class="hierarchy xhtCellBorder1">Were you/they pregnant/Hapu at the time of your/their vaccination?</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / </span>p03-EarlyOnsetReactions</td><td style="" class="hierarchy xhtCellBorder1">Early onset reactions</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck100.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p03-EarlyOnsetReactions / </span>p03-q01-SelectedSideEffects</td><td style="" class="hierarchy xhtCellBorder1">Did you/they experience any of the following after vaccination? (choose all that apply)</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"><span><span>[not stated]: None of the above (None of the above)</span></span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / </span>p04-Reactions</td><td style="" class="hierarchy xhtCellBorder1">Reactions</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q01-ReactionsIntro</td><td style="" class="hierarchy xhtCellBorder1">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.</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q02-InjectionSiteDisorder</td><td style="" class="hierarchy xhtCellBorder1">Injection site reaction (pain, redness, swelling, or itching at or near the injection site)</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q04-Fever</td><td style="" class="hierarchy xhtCellBorder1">Fever (a temperature of 38°C or higher)</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q06-Swelling</td><td style="" class="hierarchy xhtCellBorder1">Swelling of glands (i.e., lymph nodes)</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q09-Chills</td><td style="" class="hierarchy xhtCellBorder1">Chills, shivering, or cold sweats</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q11-Headaches</td><td style="" class="hierarchy xhtCellBorder1">Headaches</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q13-Rash</td><td style="" class="hierarchy xhtCellBorder1">Rash (not at the injection site)</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q15-AchesPains</td><td style="" class="hierarchy xhtCellBorder1">Aches and pains</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q17-DigestiveDisorder</td><td style="" class="hierarchy xhtCellBorder1">Stomach symptoms (nausea, vomiting, diarrhoea, abdominal pain or loss of appetite)</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q19-Fatigue</td><td style="" class="hierarchy xhtCellBorder1">Fatigue or tiredness</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q21-ChestSymptoms</td><td style="" class="hierarchy xhtCellBorder1">Chest symptoms (chest pain/heaviness/tightness or heart palpitations/pounding/racing)</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q23-DifficultyBreathing</td><td style="" class="hierarchy xhtCellBorder1">Difficulty breathing</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q25-Dizziness</td><td style="" class="hierarchy xhtCellBorder1">Dizziness or feeling lightheaded</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck100.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / </span>p04-q27-OtherSymptoms</td><td style="" class="hierarchy xhtCellBorder1">Did you/they experience any symptoms that were not listed above?</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">false</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck11.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / </span>p05-DailyImpact</td><td style="" class="hierarchy xhtCellBorder1">Impact on daily activities</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p05-DailyImpact / </span>p05-q01-MissedWork</td><td style="" class="hierarchy xhtCellBorder1">Did any of the symptoms that you/they reported cause you/them to miss work, study, or normal daily activities?</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">true</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck100.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p05-DailyImpact / </span>p05-q02-MissedWorkDetail</td><td style="" class="hierarchy xhtCellBorder1">How many days did you miss?</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"><span><span>[not stated]: Less than 1 day (Less than 1 day)</span></span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / </span>p06-CareSought</td><td style="" class="hierarchy xhtCellBorder1">Medical advice/care sought</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p06-CareSought / </span>p06-q01-SymptomRelief</td><td style="" class="hierarchy xhtCellBorder1">Did any of the symptoms cause you/them to seek advice or care from a healthcare professional?</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">true</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck100.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p06-CareSought / </span>p06-q02-SymptomReliefDetail</td><td style="" class="hierarchy xhtCellBorder1">Please choose the type of advice or care you/they sought. Please choose all that apply</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck11.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / </span>p07-VaccinationExperience</td><td style="" class="hierarchy xhtCellBorder1">Vaccination experience</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p07-VaccinationExperience / </span>p07-q01-OverallExperience</td><td style="" class="hierarchy xhtCellBorder1">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.</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"><span><span>[not stated]: Average (Average)</span></span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p07-VaccinationExperience / </span>p07-q02-Comments</td><td style="" class="hierarchy xhtCellBorder1">Do you/they have any comments about your/their vaccine experience?</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">true</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck100.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / p07-VaccinationExperience / </span>p07-q03-CommentsDetail</td><td style="" class="hierarchy xhtCellBorder1">Please explain</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">ASsA</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck00.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ActiveMonitoringDay3SurveyQuestionnaireResponse / </span>p08-Thanks</td><td style="" class="hierarchy xhtCellBorder1">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.</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr><td colspan="4" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
</text>
<questionnaire
value="https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/ActiveMonitoringDay3Survey"/>
<status value="completed"/>
<subject>
<type value="Patient"/>
<identifier>
<use value="official"/>
<system value="https://standards.digital.health.nz/ns/nhi-id"/>
<value value="ZJR6390"/>
</identifier>
<display value="No vaccine Curnow"/>
</subject>
<authored value="2024-04-21T22:06:45.669Z"/>
<author>
<type value="Patient"/>
<identifier>
<use value="official"/>
<system value="https://standards.digital.health.nz/ns/nhi-id"/>
<value value="ZJR6390"/>
</identifier>
<display value="No vaccine Curnow"/>
</author>
<item>
<linkId value="p01-Intro"/>
<text
value="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>
<valueString value="Immunization/452fb7d0-8d3d-4534-a147-25560206edc2"/>
</answer>
</item>
<item>
<linkId value="p02-Screening"/>
<text value="Screening"/>
<item>
<linkId value="p02-q01-VaccineType"/>
<text
value="Please confirm the vaccine(s) that you or your dependent (e.g., child) received 3 days ago"/>
<answer>
<valueCoding>
<code value="Only flu vaccine"/>
<display value="Only flu vaccine"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="p02-q02-SideEffects"/>
<text
value="We would like to confirm your answer to the invitation text message. Did you experience any side effects after vaccination?"/>
<answer>
<valueCoding>
<code value="Yes"/>
<display value="Yes"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="p02-q03-SideEffectsScreening"/>
<item>
<linkId value="p02-q03.1-WhoReceived"/>
<text value="Who received the vaccine?"/>
<answer>
<valueCoding>
<code value="Myself"/>
<display value="Myself"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="p02-q03.2-WhereReceived"/>
<text
value="Where did you/they go to receive your/their vaccination?"/>
<answer>
<valueCoding>
<code value="Community vaccination centre"/>
<display value="Community vaccination centre"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="p02-q03.3-Pregnant"/>
<text
value="Were you/they pregnant/Hapu at the time of your/their vaccination?"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
</item>
</item>
<item>
<linkId value="p03-EarlyOnsetReactions"/>
<text value="Early onset reactions"/>
<item>
<linkId value="p03-q01-SelectedSideEffects"/>
<text
value="Did you/they experience any of the following after vaccination? (choose all that apply)"/>
<answer>
<valueCoding>
<code value="None of the above"/>
<display value="None of the above"/>
</valueCoding>
</answer>
</item>
</item>
<item>
<linkId value="p04-Reactions"/>
<text value="Reactions"/>
<item>
<linkId value="p04-q01-ReactionsIntro"/>
<text
value="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>
<item>
<linkId value="p04-q02-InjectionSiteDisorder"/>
<text
value="Injection site reaction (pain, redness, swelling, or itching at or near the injection site)"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q04-Fever"/>
<text value="Fever (a temperature of 38°C or higher)"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q06-Swelling"/>
<text value="Swelling of glands (i.e., lymph nodes)"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q09-Chills"/>
<text value="Chills, shivering, or cold sweats"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q11-Headaches"/>
<text value="Headaches"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q13-Rash"/>
<text value="Rash (not at the injection site)"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q15-AchesPains"/>
<text value="Aches and pains"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q17-DigestiveDisorder"/>
<text
value="Stomach symptoms (nausea, vomiting, diarrhoea, abdominal pain or loss of appetite)"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q19-Fatigue"/>
<text value="Fatigue or tiredness"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q21-ChestSymptoms"/>
<text
value="Chest symptoms (chest pain/heaviness/tightness or heart palpitations/pounding/racing)"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q23-DifficultyBreathing"/>
<text value="Difficulty breathing"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q25-Dizziness"/>
<text value="Dizziness or feeling lightheaded"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="p04-q27-OtherSymptoms"/>
<text
value="Did you/they experience any symptoms that were not listed above?"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
</item>
<item>
<linkId value="p05-DailyImpact"/>
<text value="Impact on daily activities"/>
<item>
<linkId value="p05-q01-MissedWork"/>
<text
value="Did any of the symptoms that you/they reported cause you/them to miss work, study, or normal daily activities?"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
<item>
<linkId value="p05-q02-MissedWorkDetail"/>
<text value="How many days did you miss?"/>
<answer>
<valueCoding>
<code value="Less than 1 day"/>
<display value="Less than 1 day"/>
</valueCoding>
</answer>
</item>
</item>
<item>
<linkId value="p06-CareSought"/>
<text value="Medical advice/care sought"/>
<item>
<linkId value="p06-q01-SymptomRelief"/>
<text
value="Did any of the symptoms cause you/them to seek advice or care from a healthcare professional?"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
<item>
<linkId value="p06-q02-SymptomReliefDetail"/>
<text
value="Please choose the type of advice or care you/they sought. Please choose all that apply"/>
<answer>
<valueCoding>
<code value="Phone advice from a helpline e.g., Healthline"/>
<display value="Phone advice from a helpline (e.g., Healthline)"/>
</valueCoding>
</answer>
<answer>
<valueCoding>
<code value="Whānau Ora navigator"/>
<display value="Whānau Ora navigator"/>
</valueCoding>
</answer>
</item>
</item>
<item>
<linkId value="p07-VaccinationExperience"/>
<text value="Vaccination experience"/>
<item>
<linkId value="p07-q01-OverallExperience"/>
<text
value="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>
<valueCoding>
<code value="Average"/>
<display value="Average"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="p07-q02-Comments"/>
<text
value="Do you/they have any comments about your/their vaccine experience?"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
<item>
<linkId value="p07-q03-CommentsDetail"/>
<text value="Please explain"/>
<answer>
<valueString value="ASsA"/>
</answer>
</item>
</item>
<item>
<linkId value="p08-Thanks"/>
<text
value="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."/>
</item>
</QuestionnaireResponse>