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
This page describes the decision support logic included in the WHO Digital Adaptation Kit (DAK): SMART Guidelines for Immunizations (link forthcoming).
The decision-support logic component provides the decision logic and algorithms, as well as the scheduling of services, in accordance with WHO guidelines. The decision logic and algorithms in this implementation guide deconstruct the recommendations within the immunization guidelines and guidance into a machine readable format that clearly labels the inputs and outputs that would be operationalized in a digital decision-support system, such as an electronic immunization registry (EIR).
The table below provides an overview of the decision-support tables and algorithms for the different business processes in an EIR. The structure of the decision-support tables is based on an adaptation of the Decision Model and Notation (DMN™), an industry standard for modelling and executing decision logic. These decision-support tables detail the business rules, data inputs and outputs to support EIR business processes.
Overview of decision support tables for vaccine delivery (Measles excerpt)
| Activity ID & Activity Name | Decision Table ID | Decision Table Description | Reference/Source |
|---|---|---|---|
| IMMZ.G2.Determine required vaccinations if any | IMMZ.DT.01.BCG | If child or person has not been vaccinated, give BCG vaccine as soon as possible after birth | WHO recommendations for routine immunization - summary tables: https://www.who.int/teams/immunization-vaccines-and-biologicals/policies/who-recommendations-for-routine-immunization---summary-tables |
| ... | ... | ||
| IMMZ.DT.08.Measles | If the child or client has not been given MCV1 (usually at 9 months) and MCV2 (usually between 15-18 months) vaccination | ||
| ... | ... |
| Number of birth doses administered | Age in Months | Number of weeks since last dose | Number of doses administered | HIV status | Patient is currently receiving ART | Patient is currently pregnant | Immune reconstitution was achieved | CD4+ T Lymphocyte monitoring is available | Number of months since HAART was initiated | Current vaccination status | Decision | Annotation |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 | >6 and <9 | N/A | N/A | Positive | FALSE | N/A | N/A | N/A | N/A | No doses | Should vaccinate patient for measles (supplimentary) | See note 1 |
| 0 | >=9 | N/A | 0 | N/A | N/A | FALSE | N/A | N/A | N/A | No doses | Should vaccinate patient for measles | See note 2 |
| 0 | >=12 | N/A | 0 | N/A | N/A | FALSE | N/A | N/A | N/A | No doses | Should vaccinate patient for measles | See note 3 |
| 1 | >=15 | >=4 | 1 | N/A | N/A | FALSE | N/A | N/A | N/A | 1 Dose | Should vaccinate patient for measles | N/A |
| N/A | N/A | N/A | N/A | Positive | TRUE | FALSE | TRUE | N/A | N/A | Supplimentary | Should vaccinate patient for measles supplimentary dose | See note 4 |
| N/A | N/A | N/A | N/A | Positive | TRUE | FALSE | N/A | FALSE | >=6 and <=12 | Supplimentary | Should vaccinate patient for measles supplimentary dose | N/A |
Note 1: Refer to the first note in the CSV data for specifics on the supplementary dose.
Note 2: This dose is applicable if the patient is in a setting where there is high transmission of Measles.
Note 3: This dose is applicable if the patient is in a setting where there is low transmission of Measles.
Note 4: This dose is applicable if immune reconstitution was achieved for the individual following HAART.