WHO SMART Guidelines - Measles Immunization
0.1.0 - ci-build

WHO SMART Guidelines - Measles Immunization, published by WHO. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-example-immz and changes regularly. See the Directory of published versions

: IMMZ.D2.DT.Measles Ongoing Transmission - JSON Representation

Draft as of 2024-08-12

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{
  "resourceType" : "PlanDefinition",
  "id" : "IMMZD2DTMeaslesOT",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"🔗 ,
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      "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishableplandefinition"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: PlanDefinition IMMZD2DTMeaslesOT</b></p><a name=\"IMMZD2DTMeaslesOT\"> </a><a name=\"hcIMMZD2DTMeaslesOT\"> </a><a name=\"IMMZD2DTMeaslesOT-en-US\"> </a><p><b>url</b>: <a href=\"PlanDefinition-IMMZD2DTMeaslesOT.html\">PlanDefinition IMMZ.D2.DT.Measles Ongoing Transmission</a></p><p><b>version</b>: 0.1.0</p><p><b>name</b>: IMMZD2DTMeaslesOT</p><p><b>title</b>: IMMZ.D2.DT.Measles Ongoing Transmission</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/plan-definition-type eca-rule}\">ECA Rule</span></p><p><b>status</b>: Draft</p><p><b>experimental</b>: true</p><p><b>date</b>: 2024-08-12 09:03:21+0000</p><p><b>publisher</b>: WHO</p><p><b>contact</b>: WHO: <a href=\"http://who.int\">http://who.int</a></p><p><b>description</b>: </p><div><p>If the child or patient has not been given MCV1 (at 9 months) and MCV2 (between 15-18 months) vaccination</p>\n</div><h3>RelatedArtifacts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Citation</b></td></tr><tr><td style=\"display: none\">*</td><td>Citation</td><td><div><p>WHO recommendations for routine immunization - summary tables (March 2023)</p>\n</div></td></tr></table><p><b>library</b>: <a href=\"Library-IMMZD2DTMeaslesOTLogic.html\">IMMZD2DTMeaslesOTLogic</a></p><blockquote><p><b>action</b></p><p><b>title</b>: Immunize patient for Measles</p><blockquote><p><b>condition</b></p><p><b>kind</b>: Applicability</p><h3>Expressions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>text/cql-identifier</td><td>Measles Routine Immunization Schedule Incomplete</td></tr></table></blockquote><blockquote><p><b>action</b></p></blockquote><blockquote><p><b>action</b></p></blockquote><blockquote><p><b>action</b></p></blockquote></blockquote></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability",
      "valueCode" : "computable"
    }
  ],
  "url" : "http://smart.who.int/immunizations-measles/PlanDefinition/IMMZD2DTMeaslesOT",
  "version" : "0.1.0",
  "name" : "IMMZD2DTMeaslesOT",
  "title" : "IMMZ.D2.DT.Measles Ongoing Transmission",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule"
      }
    ]
  },
  "status" : "draft",
  "experimental" : true,
  "date" : "2024-08-12T09:03:21+00:00",
  "publisher" : "WHO",
  "contact" : [
    {
      "name" : "WHO",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://who.int"
        }
      ]
    }
  ],
  "description" : "If the child or patient has not been given MCV1 (at 9 months) and MCV2 (between 15-18 months) vaccination",
  "relatedArtifact" : [
    {
      "type" : "citation",
      "citation" : "WHO recommendations for routine immunization - summary tables (March 2023)"
    }
  ],
  "library" : [
    🔗 "http://smart.who.int/immunizations-measles/Library/IMMZD2DTMeaslesOTLogic"
  ],
  "action" : [
    {
      "title" : "Immunize patient for Measles",
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "language" : "text/cql-identifier",
            "expression" : "Measles Routine Immunization Schedule Incomplete"
          }
        }
      ],
      "action" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale",
              "valueMarkdown" : "In countries with ongoing transmission in which the risk of measles mortality remains high, MCV1 should be given at age 9 months.<br/>As a general rule, live vaccines should be given either simultaneously or at intervals of 4 weeks. An exception to this rule is OPV, which can be given at any time before or after measles vaccination without interference in the response to either vaccine."
            }
          ],
          "title" : "Provide primary series measles vaccination (MCV1)",
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql-identifier",
                "expression" : "No Primary Series Doses Administered"
              }
            }
          ],
          "action" : [
            {
              "title" : "Client Age Less Than 9 Months",
              "description" : "Should not vaccinate client as client's age is less than 9 months. Check for any vaccines due, and inform the caregiver of when to come back for MCV1.",
              "condition" : [
                {
                  "kind" : "applicability",
                  "expression" : {
                    "language" : "text/cql-identifier",
                    "expression" : "Client Age Less Than 9 Months"
                  }
                }
              ]
            },
            {
              "title" : "Last Live Vaccine Administered Within 4 Weeks",
              "description" : "Should not vaccinate client for MCV1 as live vaccine was administered in the last 4 weeks. Check for any vaccines due and inform the caregiver of when to come back for MCV1.",
              "condition" : [
                {
                  "kind" : "applicability",
                  "expression" : {
                    "language" : "text/cql-identifier",
                    "expression" : "Last Live Vaccine Administered Within 4 Weeks"
                  }
                }
              ]
            },
            {
              "title" : "Provide Measles Vaccine",
              "description" : "Should vaccinate client for MCV1 as no measles doses were administered, client is within appropriate age range and no live vaccine administered in the last 4 weeks. Check for contraindications.",
              "condition" : [
                {
                  "kind" : "applicability",
                  "expression" : {
                    "language" : "text/cql-identifier",
                    "expression" : "Client Is Due For MCV1"
                  }
                }
              ],
              "definitionCanonical" : "http://smart.who.int/immunizations-measles/ActivityDefinition/IMMZD2DTMeaslesMR",
              "dynamicValue" : [
                {
                  "path" : "dispenseRequest.validityPeriod.start",
                  "expression" : {
                    "description" : "Due date of the dose",
                    "language" : "text/cql-identifier",
                    "expression" : "MCV1 Schedule Date"
                  }
                },
                {
                  "path" : "dispenseRequest.validityPeriod.end",
                  "expression" : {
                    "description" : "Expiration date for MCV dose",
                    "language" : "text/cql-identifier",
                    "expression" : "MCV1 Expiration Date"
                  }
                }
              ]
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale",
              "valueMarkdown" : "In countries with ongoing transmission in which the risk of measles mortality remains high, MCV2 should be given between 15-18 months. The minimum interval between MCV1 and MCV2 is 4 weeks.<br/>As a general rule, live vaccines should be given either simultaneously or at intervals of 4 weeks. An exception to this rule is OPV, which can be given at any time before or after measles vaccination without interference in the response to either vaccine."
            }
          ],
          "title" : "Provide primary series measles vaccination (MCV2)",
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql-identifier",
                "expression" : "One Primary Series Dose Administered"
              }
            }
          ],
          "action" : [
            {
              "title" : "Client Age Less Than 15 Months",
              "description" : "Should not vaccinate client for MCV2 as client's age is less than 15 months. Check for any vaccines due, and inform the caregiver of when to come back for MCV2.",
              "condition" : [
                {
                  "kind" : "applicability",
                  "expression" : {
                    "language" : "text/cql-identifier",
                    "expression" : "Client Age Less Than 15 Months"
                  }
                }
              ]
            },
            {
              "title" : "Last Live Vaccine Administered Within 4 Weeks",
              "description" : "Should not vaccinate client for MCV2 as live vaccine was administered in the last 4 weeks. Check for any vaccines due, and inform the caregiver of when to come back for MCV2.",
              "condition" : [
                {
                  "kind" : "applicability",
                  "expression" : {
                    "language" : "text/cql-identifier",
                    "expression" : "Last Live Vaccine Administered Within 4 Weeks"
                  }
                }
              ]
            },
            {
              "title" : "Provide Measles Vaccine",
              "description" : "Should vaccinate client for MCV2 as client is within appropriate age range and no live vaccine administered in the last 4 weeks. Check for contraindications.",
              "condition" : [
                {
                  "kind" : "applicability",
                  "expression" : {
                    "language" : "text/cql-identifier",
                    "expression" : "Client Is Due For MCV2"
                  }
                }
              ],
              "definitionCanonical" : "http://smart.who.int/immunizations-measles/ActivityDefinition/IMMZD2DTMeaslesMR",
              "dynamicValue" : [
                {
                  "path" : "dispenseRequest.validityPeriod.start",
                  "expression" : {
                    "description" : "Due date of the dose",
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                    "expression" : "MCV2 Schedule Date"
                  }
                },
                {
                  "path" : "dispenseRequest.validityPeriod.end",
                  "expression" : {
                    "description" : "Expiration date for MCV dose",
                    "language" : "text/cql-identifier",
                    "expression" : "MCV2 Expiration Date"
                  }
                }
              ]
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale",
              "valueMarkdown" : "An additional dose of MCV should be administered to HIV-infected children receiving HAART following immune reconstitution. If CD4+ T lymphocyte counts are monitored, an additional dose of MCV should be administered when immune reconstitution has been achieved, e.g. when the CD4+ T lymphocyte count reaches 20–25%. Where CD4+ T lymphocyte monitoring is not available, children should receive an additional dose of MCV 6–12 months after initiation of HAART."
            }
          ],
          "title" : "Measles primary series is complete",
          "description" : "Measles primary series is complete. Two measles primary series doses were administered. Check if a measles supplementary dose is appropriate for the client.",
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
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                "expression" : "Two Primary Series Doses Administered"
              }
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  ]
}