The FHIR Immunization resource addresses only immunizations that have been administered. The FHIR ImmunizationRecommendation resource addresses only immunization forecasting, such as that provided by a forecasting engine / clinical decision support. The modeling is inconsistent with the was comparable items are modeled in FHIR - e.g., MedicationRequest, ReferralRequest and ProcedureRequest. Each of these resources includes an .intent metadata element that allows reference to "proposal" consistent with clinical decision support forecasting, "plan" consistent with a recommendation a clinician provides to a patient, and "order" consistent with an order placed in EHRs or other clinical software. This is an important distinction since in some practices, the physician sends a prescription (order) to a pharmacy for the patient to pick up, bring back to the practice for it to be administered. To further support immunization orders, ImmunizationRecommendation needs to support doseQuantity and route (which are part of the order). The current metadata only allows specification of a forecast that includes dose number and sequence in a series.