^V04
VXU^V04 — Unsolicited Vaccination Record Update
Used to report vaccination administration to an immunization information system (IIS) or state immunization registry. It carries the vaccine administered, dose details, and patient demographics.
When Is This Sent?
When a vaccine is administered and the clinical system needs to report the vaccination to a state or regional immunization registry (e.g., after childhood immunizations, flu shots, or COVID-19 vaccinations).
Real-World Usage
VXU^V04 is mandatory for immunization registry reporting in most US states. RXA.5 carries the vaccine code using CVX (CDC vaccine codes) and RXA.17 carries the manufacturer using MVX codes. If vaccinations aren't appearing in the state registry, check CVX code mapping — codes must match the registry's expected values exactly.
Message Structure
Segment names link to their field-level reference pages.
| # | Segment | Purpose in this message | Req | Repeat |
|---|---|---|---|---|
| 1 | MSH | Message header with VXU^V04 in MSH.9 | R | — |
| 2 | PID | Patient demographics — required for registry patient matching | R | — |
| 3 | ORC | Order common segment | R | — |
| 4 | RXA | Vaccination administration details: vaccine code, dose, date administered | R | — |
| 5 | NK1 | Guardian/parent for pediatric patients | O | — |
| 6 | PD1 | Patient additional demographics including immunization registry status | O | — |
| 7 | GT1 | Guarantor/responsible person | O | — |
| 8 | IN1 | Insurance information | O | — |
| 9 | OBX | Vaccination observations (e.g., VIS document publication date) | O | Yes |
| 10 | RXR | Route and site of administration | O | — |
Example Message
Realistic example with fake patient data. Paste into the HL7 Message Viewer to explore interactively.
1MSH||^~\&|EHR|CLINIC_A|STATE_IIS|REGISTRY|20260310143000||VXU^V04^VXU_V04|VXU00001|P|2.5.1 2PID||1||CLINIC123456^^^CLINIC_A^MR||Garcia^Maria^L||20190801|F|||100 Elm St^^Chicago^IL^60601^US^H||3125554321^PRN^PH 3ORC||RE 4RXA||0|1|20260310143000|20260310143000|94^MMR^CVX|0.5|mL|01^Historical^NIP001|||||||^Merck^^^^MFR|^LOT20261231^^20261231|A|20261231|CP|A
Troubleshooting Scenarios
Vaccinations not appearing in state registry
Cause
CVX codes in RXA.5 don't match the codes expected by the state registry. The registry uses a specific CVX code version.
Fix
Obtain the current CVX code list from the state registry or CDC. Map your local vaccine codes to CVX codes in your interface engine. CVX code 94 = MMRV vaccine, 03 = MMR vaccine — using the wrong one will cause the vaccination to be rejected.
Common Confusions
VXU^V04 (Unsolicited vaccination update) vs QBP (query for vaccination history). VXU^V04 pushes vaccination data to a registry. To query the registry for a patient's existing vaccination history, use a query message (QBP^Q11). Most EHR-to-registry interfaces use VXU^V04 exclusively.
Related Message Types
Segment Reference
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