Adverse Events Following Immunization Data Submission and Response Guidelines Alberta Health Version 6.9 January 2020 Superseded Alberta Health Adverse Events to Immunization Data Submission and Response Guidelines January 2020 Table of Contents A. DATA SUBMISSION GUIDELINE ........................................................................................................ 1 1. INTRODUCTION ..................................................................................................................................... 1 2. SUBMISSION FILE NAMING CONVENTION ................................................................................................ 2 3. SUBMISSION FILE STRUCTURE .............................................................................................................. 3 Overview ................................................................................................................................................ 3 Record Descriptions ............................................................................................................................... 4 Version Record .................................................................................................................................................. 4 Header Record ................................................................................................................................................... 4 Patient Record ................................................................................................................................................... 5 Adverse Event Record ....................................................................................................................................... 5 Immunization Record ......................................................................................................................................... 7 Adverse Event Detail Record ............................................................................................................................. 8 Footer Record .................................................................................................................................................... 9 4. SUBMISSION TYPE USAGE ................................................................................................................... 10 Rules for Adding Data .......................................................................................................................... 10 Rules for Deleting Data ........................................................................................................................ 10 Rules for Changing Data...................................................................................................................... 10 5. DATA ELEMENTS ................................................................................................................................ 11 Version Record .................................................................................................................................... 12 Record Type ..................................................................................................................................................... 12 DSG Version Number....................................................................................................................................... 12 Record Type ..................................................................................................................................................... 13 Submitter Prefix ................................................................................................................................................ 14 Batch Number .................................................................................................................................................. 16 Patient Record ..................................................................................................................................... 17 Record Type ..................................................................................................................................................... 17 Record Number ................................................................................................................................................ 17 Unique Lifetime Identifier (ULI) ......................................................................................................................... 17 Provincial Health Number Type ........................................................................................................................ 18 Provincial Health Number ................................................................................................................................. 18 Alternate Person Identifier Type ....................................................................................................................... 19 Alternate Person Identifier ................................................................................................................................ 19 Last Name ........................................................................................................................................................ 19 Given Name ..................................................................................................................................................... 20 Middle Name .................................................................................................................................................... 20 Address Type ................................................................................................................................................... 20 Street Address 1 .............................................................................................................................................. 20 Street Address 2 .............................................................................................................................................. 21 Street Address 3 .............................................................................................................................................. 21 Street Address 4 .............................................................................................................................................. 21 City Name ........................................................................................................................................................ 21 Province Code .................................................................................................................................................. 22 Country Code ................................................................................................................................................... 22 Postal Code ...................................................................................................................................................... 28 Quarter Section Code ...................................................................................................................................... 28 Section ............................................................................................................................................................. 29 Township .......................................................................................................................................................... 29 Range............................................................................................................................................................... 29 Meridian ................................................................................................Superseded........................................................... 30 Birth Date ......................................................................................................................................................... 30 Gender Code .................................................................................................................................................... 30 Homeless/Indigent Flag .................................................................................................................................... 31 Adverse Event Record ......................................................................................................................... 32 Record Type ..................................................................................................................................................... 32 Record Number ................................................................................................................................................ 32 Unique Lifetime Identifier (ULI) ......................................................................................................................... 32 AEFI Number ................................................................................................................................................... 33 Submission Type .............................................................................................................................................. 33 ________________________________________________________________________________________________________ © 2020 Government of Alberta