The HL7 CQI Workgroup reviewed the use of CVX codes in QRDA reporting. A temporary solution was recommended:

"Add guidance that when CVX codes are used, use the medication template and use "nullFlavor" using the snippet shown below:

<code nullFlavor="OTH">
<translation code="48" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX" sdtc:valueSet="2.16.840.1.113883.3.464.1003.196.12.1217">
<originalText>Medication, Administered: Hemophilus influenzae B (HiB) Vaccine (Code List: 2.16.840.1.113883.3.464.1003.196.12.1217)</originalText>
</translation>
</code>

For future ballot, consider adding immunization template to QRDA and suggest addition of immunization to the Quality Data Model (QDM) to regain alignment with consolidated CDA."

The solution is not ideal since it causes QRDA to be out of alignment with its parent structure, consolidated CDA. Ideally, the QDM should align with the underlying standards used to express information for interoperability. QDM needs to change by adding an immunization datatype set, QRDA can be brought into alignment with cCDA.