<?xml version="1.0" encoding="UTF-8"?>
<library xmlns="urn:hl7-org:elm:r1" xmlns:t="urn:hl7-org:elm-types:r1" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:fhir="http://hl7.org/fhir" xmlns:qdm43="urn:healthit-gov:qdm:v4_3" xmlns:qdm53="urn:healthit-gov:qdm:v5_3" xmlns:a="urn:hl7-org:cql-annotations:r1" localId="0">
   <annotation translatorOptions="EnableAnnotations,EnableLocators,DisableListDemotion,DisableListPromotion" signatureLevel="Overloads" xsi:type="a:CqlToElmInfo"/>
   <annotation message="An operand identifier reference is hiding another identifier of the same name." errorType="semantic" errorSeverity="warning" xsi:type="a:CqlToElmError"/>
   <annotation message="An operand identifier reference is hiding another identifier of the same name." errorType="semantic" errorSeverity="warning" xsi:type="a:CqlToElmError"/>
   <annotation message="An operand identifier reference is hiding another identifier of the same name." errorType="semantic" errorSeverity="warning" xsi:type="a:CqlToElmError"/>
   <annotation xsi:type="a:Annotation">
      <a:s r="640">
         <a:s>/*
 * Library: IMMZD2DTPneumococcal2DosesWithBoosterDoseLogic (IMMZ.D2.DT.Pneumococcal.2 doses with booster dose)
 * Rule: Determine if the client is due for a pneumococcal vaccination according to the national immunization schedule
 * Decision Table: 2 primary doses with a booster dose (2p+1)
 * Trigger: IMMZ.D2 Determine required vaccination(s) if any
 */
library IMMZD2DTPneumococcal2DosesWithBoosterDoseLogic</a:s>
      </a:s>
   </annotation>
   <identifier id="IMMZD2DTPneumococcal2DosesWithBoosterDoseLogic" system="http://smart.who.int/immunizations"/>
   <schemaIdentifier id="urn:hl7-org:elm" version="r1"/>
   <usings>
      <def localId="1" localIdentifier="System" uri="urn:hl7-org:elm-types:r1" version="1.0.0"/>
      <def localId="206" locator="9:1-9:26" localIdentifier="FHIR" uri="http://hl7.org/fhir" version="4.0.1">
         <annotation xsi:type="a:Annotation">
            <a:s r="206">
               <a:s>using </a:s>
               <a:s>
                  <a:s>FHIR</a:s>
               </a:s>
               <a:s> version '4.0.1'</a:s>
            </a:s>
         </annotation>
      </def>
   </usings>
   <includes>
      <def localId="208" locator="10:1-10:35" localIdentifier="FHIRHelpers" path="http://hl7.org/fhir/FHIRHelpers" version="4.0.1">
         <annotation xsi:type="a:Annotation">
            <a:s r="208">
               <a:s>include </a:s>
               <a:s>
                  <a:s>FHIRHelpers</a:s>
               </a:s>
               <a:s> version '4.0.1'</a:s>
            </a:s>
         </annotation>
      </def>
      <def localId="210" locator="12:1-12:62" localIdentifier="Encounter" path="http://smart.who.int/immunizations/IMMZD2DTPneumococcalEncounterElements">
         <annotation xsi:type="a:Annotation">
            <a:s r="210">
               <a:s>include </a:s>
               <a:s>
                  <a:s>IMMZD2DTPneumococcalEncounterElements</a:s>
               </a:s>
               <a:s> called Encounter</a:s>
            </a:s>
         </annotation>
      </def>
   </includes>
   <parameters>
      <def localId="212" locator="14:1-14:36" name="Today" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:s r="212">
               <a:s>parameter Today </a:s>
               <a:s r="216">
                  <a:s>Date</a:s>
               </a:s>
               <a:s> default </a:s>
               <a:s r="215">
                  <a:s>Today()</a:s>
               </a:s>
            </a:s>
         </annotation>
         <default localId="215" locator="14:30-14:36" xsi:type="Today"/>
         <parameterTypeSpecifier localId="216" locator="14:17-14:20" name="t:Date" xsi:type="NamedTypeSpecifier"/>
      </def>
   </parameters>
   <contexts>
      <def localId="221" locator="16:1-16:15" name="Patient"/>
   </contexts>
   <statements>
      <def localId="219" locator="16:1-16:15" name="Patient" context="Patient">
         <expression localId="220" xsi:type="SingletonFrom">
            <operand localId="218" locator="16:1-16:15" dataType="fhir:Patient" templateId="http://hl7.org/fhir/StructureDefinition/Patient" xsi:type="Retrieve"/>
         </expression>
      </def>
      <def localId="234" locator="40:1-41:51" name="Client is not due for pneumococcal vaccination Case 1" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is not due for pneumococcal vaccination Case 1"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Not due&quot;"/>
            <a:s r="234">
               <a:s>/*
@output: Client is not due for pneumococcal vaccination Case 1
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for pneumococcal vaccination Case 1&quot;:
  </a:s>
               <a:s r="236">
                  <a:s r="235">
                     <a:s>Encounter</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="236">
                     <a:s>&quot;The client's age is less than 6 weeks&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="236" locator="41:3-41:51" name="The client's age is less than 6 weeks" libraryName="Encounter" xsi:type="ExpressionRef"/>
      </def>
      <def localId="240" locator="47:1-51:87" name="Client is not due for pneumococcal vaccination Case 2" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is not due for pneumococcal vaccination Case 2"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Not due&quot;"/>
            <a:s r="240">
               <a:s>/*
@output: Client is not due for pneumococcal vaccination Case 2
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for pneumococcal vaccination Case 2&quot;:
  </a:s>
               <a:s r="241">
                  <a:s r="242">
                     <a:s r="243">
                        <a:s r="245">
                           <a:s r="244">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="245">
                              <a:s>&quot;One pneumococcal primary series dose was administered&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="247">
                           <a:s r="246">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="247">
                              <a:s>&quot;The client's age is less than or equal to 5 years&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="249">
                        <a:s r="248">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="249">
                           <a:s>&quot;The first pneumococcal dose was administered within 24 months post birth&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="251">
                     <a:s r="250">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="251">
                        <a:s>&quot;The latest pneumococcal dose was administered less than 8 weeks ago&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="241" locator="48:3-51:87" xsi:type="And">
            <operand localId="242" locator="48:3-50:92" xsi:type="And">
               <operand localId="243" locator="48:3-49:69" xsi:type="And">
                  <operand localId="245" locator="48:3-48:67" name="One pneumococcal primary series dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  <operand localId="247" locator="49:9-49:69" name="The client's age is less than or equal to 5 years" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="249" locator="50:9-50:92" name="The first pneumococcal dose was administered within 24 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="251" locator="51:9-51:87" name="The latest pneumococcal dose was administered less than 8 weeks ago" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="255" locator="57:1-62:69" name="Client is not due for pneumococcal vaccination Case 3" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is not due for pneumococcal vaccination Case 3"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Not due&quot;"/>
            <a:s r="255">
               <a:s>/*
@output: Client is not due for pneumococcal vaccination Case 3
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for pneumococcal vaccination Case 3&quot;:
  </a:s>
               <a:s r="256">
                  <a:s r="257">
                     <a:s r="258">
                        <a:s r="259">
                           <a:s r="261">
                              <a:s r="260">
                                 <a:s>Encounter</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="261">
                                 <a:s>&quot;One pneumococcal primary series dose was administered&quot;</a:s>
                              </a:s>
                           </a:s>
                           <a:s>
    and </a:s>
                           <a:s r="263">
                              <a:s r="262">
                                 <a:s>Encounter</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="263">
                                 <a:s>&quot;The client's age is less than or equal to 5 years&quot;</a:s>
                              </a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="265">
                           <a:s r="264">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="265">
                              <a:s>&quot;The first pneumococcal dose was administered after 24 months post birth&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="267">
                        <a:s r="266">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="267">
                           <a:s>&quot;The latest pneumococcal dose was administered less than 8 weeks ago&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="269">
                     <a:s r="268">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="269">
                        <a:s>&quot;Client is at high risk for pneumococcal infection&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="256" locator="58:3-62:69" xsi:type="And">
            <operand localId="257" locator="58:3-61:87" xsi:type="And">
               <operand localId="258" locator="58:3-60:91" xsi:type="And">
                  <operand localId="259" locator="58:3-59:69" xsi:type="And">
                     <operand localId="261" locator="58:3-58:67" name="One pneumococcal primary series dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                     <operand localId="263" locator="59:9-59:69" name="The client's age is less than or equal to 5 years" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="265" locator="60:9-60:91" name="The first pneumococcal dose was administered after 24 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="267" locator="61:9-61:87" name="The latest pneumococcal dose was administered less than 8 weeks ago" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="269" locator="62:9-62:69" name="Client is at high risk for pneumococcal infection" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="229" locator="68:1-71:62" name="Client is not due for pneumococcal vaccination" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is not due for pneumococcal vaccination"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Not due&quot;"/>
            <a:s r="229">
               <a:s>/*
@output: Client is not due for pneumococcal vaccination
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for pneumococcal vaccination&quot;:
  </a:s>
               <a:s r="230">
                  <a:s r="231">
                     <a:s r="237">
                        <a:s>&quot;Client is not due for pneumococcal vaccination Case 1&quot;</a:s>
                     </a:s>
                     <a:s>
    or </a:s>
                     <a:s r="252">
                        <a:s>&quot;Client is not due for pneumococcal vaccination Case 2&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    or </a:s>
                  <a:s r="270">
                     <a:s>&quot;Client is not due for pneumococcal vaccination Case 3&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="230" locator="69:3-71:62" xsi:type="Or">
            <operand localId="231" locator="69:3-70:62" xsi:type="Or">
               <operand localId="237" locator="69:3-69:57" name="Client is not due for pneumococcal vaccination Case 1" xsi:type="ExpressionRef"/>
               <operand localId="252" locator="70:8-70:62" name="Client is not due for pneumococcal vaccination Case 2" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="270" locator="71:8-71:62" name="Client is not due for pneumococcal vaccination Case 3" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="274" locator="81:1-89:5" name="Client is not due for pneumococcal vaccination Guidance" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is not due for pneumococcal vaccination Guidance"/>
            <a:s r="274">
               <a:s>/*
@output: Client is not due for pneumococcal vaccination Guidance
@guidance = Should not vaccinate client with first pneumococcal dose as client's age is less than 6 weeks. Check for any vaccines due and inform the caregiver of when to come back for the first dose.
@guidance = Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.
@guidance = Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago and client is at high risk for pneumococcal infection. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.
*/
define &quot;Client is not due for pneumococcal vaccination Guidance&quot;:
  </a:s>
               <a:s r="275">
                  <a:s>case
    </a:s>
                  <a:s r="276">
                     <a:s>when </a:s>
                     <a:s r="277">
                        <a:s>&quot;Client is not due for pneumococcal vaccination Case 1&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="278">
                        <a:s>'Should not vaccinate client with first pneumococcal dose as client\'s age is less than 6 weeks. Check for any vaccines due and inform the caregiver of when to come back for the first dose.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="280">
                     <a:s>when </a:s>
                     <a:s r="281">
                        <a:s>&quot;Client is not due for pneumococcal vaccination Case 2&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="282">
                        <a:s>'Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="284">
                     <a:s>when </a:s>
                     <a:s r="285">
                        <a:s>&quot;Client is not due for pneumococcal vaccination Case 3&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="286">
                        <a:s>'Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago and client is at high risk for pneumococcal infection. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    else </a:s>
                  <a:s r="288">
                     <a:s>''</a:s>
                  </a:s>
                  <a:s>
  end</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="275" locator="82:3-89:5" xsi:type="Case">
            <caseItem localId="276" locator="83:5-83:260">
               <when localId="277" locator="83:10-83:64" name="Client is not due for pneumococcal vaccination Case 1" xsi:type="ExpressionRef"/>
               <then localId="278" locator="83:71-83:260" valueType="t:String" value="Should not vaccinate client with first pneumococcal dose as client's age is less than 6 weeks. Check for any vaccines due and inform the caregiver of when to come back for the first dose." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="280" locator="84:5-84:300">
               <when localId="281" locator="84:10-84:64" name="Client is not due for pneumococcal vaccination Case 2" xsi:type="ExpressionRef"/>
               <then localId="282" locator="84:71-84:300" valueType="t:String" value="Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago. &#xa;Check for any other vaccines due and inform the caregiver of when to come back for the next dose." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="284" locator="86:5-86:354">
               <when localId="285" locator="86:10-86:64" name="Client is not due for pneumococcal vaccination Case 3" xsi:type="ExpressionRef"/>
               <then localId="286" locator="86:71-86:354" valueType="t:String" value="Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago and client is at high risk for pneumococcal infection. &#xa;Check for any other vaccines due and inform the caregiver of when to come back for the next dose." xsi:type="Literal"/>
            </caseItem>
            <else localId="288" locator="88:10-88:11" valueType="t:String" value="" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="299" locator="95:1-97:67" name="Client is due for pneumococcal vaccination Case 1" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal vaccination Case 1"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Due&quot;"/>
            <a:s r="299">
               <a:s>/*
@output: Client is due for pneumococcal vaccination Case 1
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for pneumococcal vaccination Case 1&quot;:
  </a:s>
               <a:s r="300">
                  <a:s r="302">
                     <a:s r="301">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="302">
                        <a:s>&quot;No pneumococcal primary series doses were administered&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="304">
                     <a:s r="303">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="304">
                        <a:s>&quot;The client's age is between 6 weeks and 5 years&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="300" locator="96:3-97:67" xsi:type="And">
            <operand localId="302" locator="96:3-96:68" name="No pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
            <operand localId="304" locator="97:9-97:67" name="The client's age is between 6 weeks and 5 years" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="308" locator="103:1-107:87" name="Client is due for pneumococcal vaccination Case 2" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal vaccination Case 2"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Due&quot;"/>
            <a:s r="308">
               <a:s>/*
@output: Client is due for pneumococcal vaccination Case 2
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for pneumococcal vaccination Case 2&quot;:
  </a:s>
               <a:s r="309">
                  <a:s r="310">
                     <a:s r="311">
                        <a:s r="313">
                           <a:s r="312">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="313">
                              <a:s>&quot;One pneumococcal primary series dose was administered&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="315">
                           <a:s r="314">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="315">
                              <a:s>&quot;The client's age is less than or equal to 5 years&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="317">
                        <a:s r="316">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="317">
                           <a:s>&quot;The first pneumococcal dose was administered within 24 months post birth&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="319">
                     <a:s r="318">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="319">
                        <a:s>&quot;The latest pneumococcal dose was administered more than 8 weeks ago&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="309" locator="104:3-107:87" xsi:type="And">
            <operand localId="310" locator="104:3-106:92" xsi:type="And">
               <operand localId="311" locator="104:3-105:69" xsi:type="And">
                  <operand localId="313" locator="104:3-104:67" name="One pneumococcal primary series dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  <operand localId="315" locator="105:9-105:69" name="The client's age is less than or equal to 5 years" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="317" locator="106:9-106:92" name="The first pneumococcal dose was administered within 24 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="319" locator="107:9-107:87" name="The latest pneumococcal dose was administered more than 8 weeks ago" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="323" locator="113:1-118:69" name="Client is due for pneumococcal vaccination Case 3" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal vaccination Case 3"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Due&quot;"/>
            <a:s r="323">
               <a:s>/*
@output: Client is due for pneumococcal vaccination Case 3
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for pneumococcal vaccination Case 3&quot;:
  </a:s>
               <a:s r="324">
                  <a:s r="325">
                     <a:s r="326">
                        <a:s r="327">
                           <a:s r="329">
                              <a:s r="328">
                                 <a:s>Encounter</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="329">
                                 <a:s>&quot;One pneumococcal primary series dose was administered&quot;</a:s>
                              </a:s>
                           </a:s>
                           <a:s>
    and </a:s>
                           <a:s r="331">
                              <a:s r="330">
                                 <a:s>Encounter</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="331">
                                 <a:s>&quot;The client's age is less than or equal to 5 years&quot;</a:s>
                              </a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="333">
                           <a:s r="332">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="333">
                              <a:s>&quot;The first pneumococcal dose was administered after 24 months post birth&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="335">
                        <a:s r="334">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="335">
                           <a:s>&quot;The latest pneumococcal dose was administered more than 8 weeks ago&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="337">
                     <a:s r="336">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="337">
                        <a:s>&quot;Client is at high risk for pneumococcal infection&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="324" locator="114:3-118:69" xsi:type="And">
            <operand localId="325" locator="114:3-117:87" xsi:type="And">
               <operand localId="326" locator="114:3-116:91" xsi:type="And">
                  <operand localId="327" locator="114:3-115:69" xsi:type="And">
                     <operand localId="329" locator="114:3-114:67" name="One pneumococcal primary series dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                     <operand localId="331" locator="115:9-115:69" name="The client's age is less than or equal to 5 years" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="333" locator="116:9-116:91" name="The first pneumococcal dose was administered after 24 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="335" locator="117:9-117:87" name="The latest pneumococcal dose was administered more than 8 weeks ago" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="337" locator="118:9-118:69" name="Client is at high risk for pneumococcal infection" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="294" locator="124:1-127:58" name="Client is due for pneumococcal vaccination" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal vaccination"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Due&quot;"/>
            <a:s r="294">
               <a:s>/*
@output: Client is due for pneumococcal vaccination
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for pneumococcal vaccination&quot;:
  </a:s>
               <a:s r="295">
                  <a:s r="296">
                     <a:s r="305">
                        <a:s>&quot;Client is due for pneumococcal vaccination Case 1&quot;</a:s>
                     </a:s>
                     <a:s>
    or </a:s>
                     <a:s r="320">
                        <a:s>&quot;Client is due for pneumococcal vaccination Case 2&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    or </a:s>
                  <a:s r="338">
                     <a:s>&quot;Client is due for pneumococcal vaccination Case 3&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="295" locator="125:3-127:58" xsi:type="Or">
            <operand localId="296" locator="125:3-126:58" xsi:type="Or">
               <operand localId="305" locator="125:3-125:53" name="Client is due for pneumococcal vaccination Case 1" xsi:type="ExpressionRef"/>
               <operand localId="320" locator="126:8-126:58" name="Client is due for pneumococcal vaccination Case 2" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="338" locator="127:8-127:58" name="Client is due for pneumococcal vaccination Case 3" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="342" locator="138:1-147:5" name="Client is due for pneumococcal vaccination Guidance" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal vaccination Guidance"/>
            <a:s r="342">
               <a:s>/*
@output: Client is due for pneumococcal vaccination Guidance
@guidance = Should vaccinate client with first pneumococcal dose as no pneumococcal doses were administered and client is within the appropriate age range.
Check for contraindications.
@guidance = Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago. 
Check for contraindications.
@guidance = Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago and client is at high risk for pneumococcal infection. 
Check for contraindications.
*/
define &quot;Client is due for pneumococcal vaccination Guidance&quot;:
  </a:s>
               <a:s r="343">
                  <a:s>case
    </a:s>
                  <a:s r="344">
                     <a:s>when </a:s>
                     <a:s r="345">
                        <a:s>&quot;Client is due for pneumococcal vaccination Case 1&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="346">
                        <a:s>'Should vaccinate client with first pneumococcal dose as no pneumococcal doses were administered and client is within the appropriate age range.
Check for contraindications.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="348">
                     <a:s>when </a:s>
                     <a:s r="349">
                        <a:s>&quot;Client is due for pneumococcal vaccination Case 2&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="350">
                        <a:s>'Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago. 
Check for contraindications.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="352">
                     <a:s>when </a:s>
                     <a:s r="353">
                        <a:s>&quot;Client is due for pneumococcal vaccination Case 3&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="354">
                        <a:s>'Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago and client is at high risk for pneumococcal infection. 
Check for contraindications.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    else </a:s>
                  <a:s r="356">
                     <a:s>''</a:s>
                  </a:s>
                  <a:s>
  end</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="343" locator="139:3-147:5" xsi:type="Case">
            <caseItem localId="344" locator="140:5-140:240">
               <when localId="345" locator="140:10-140:60" name="Client is due for pneumococcal vaccination Case 1" xsi:type="ExpressionRef"/>
               <then localId="346" locator="140:67-140:240" valueType="t:String" value="Should vaccinate client with first pneumococcal dose as no pneumococcal doses were administered and client is within the appropriate age range.&#xa;Check for contraindications." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="348" locator="142:5-142:223">
               <when localId="349" locator="142:10-142:60" name="Client is due for pneumococcal vaccination Case 2" xsi:type="ExpressionRef"/>
               <then localId="350" locator="142:67-142:223" valueType="t:String" value="Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago. &#xa;Check for contraindications." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="352" locator="144:5-144:277">
               <when localId="353" locator="144:10-144:60" name="Client is due for pneumococcal vaccination Case 3" xsi:type="ExpressionRef"/>
               <then localId="354" locator="144:67-144:277" valueType="t:String" value="Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago and client is at high risk for pneumococcal infection. &#xa;Check for contraindications." xsi:type="Literal"/>
            </caseItem>
            <else localId="356" locator="146:10-146:11" valueType="t:String" value="" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="370" locator="154:1-158:73" name="Pneumococcal immunization schedule is complete Case 1" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Pneumococcal immunization schedule is complete Case 1"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Complete&quot;"/>
            <a:s r="370">
               <a:s>/*
@output: Pneumococcal immunization schedule is complete Case 1
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Complete&quot;
&quot;Completed the primary vaccination series&quot; = TRUE (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;)
*/
define &quot;Pneumococcal immunization schedule is complete Case 1&quot;:
  </a:s>
               <a:s r="371">
                  <a:s r="372">
                     <a:s r="373">
                        <a:s r="375">
                           <a:s r="374">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="375">
                              <a:s>&quot;One pneumococcal primary series dose was administered&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="377">
                           <a:s r="376">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="377">
                              <a:s>&quot;The client's age is less than or equal to 5 years&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="379">
                        <a:s r="378">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="379">
                           <a:s>&quot;The first pneumococcal dose was administered after 24 months post birth&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="381">
                     <a:s r="380">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="381">
                        <a:s>&quot;Client is not at high risk for pneumococcal infection&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="371" locator="155:3-158:73" xsi:type="And">
            <operand localId="372" locator="155:3-157:91" xsi:type="And">
               <operand localId="373" locator="155:3-156:69" xsi:type="And">
                  <operand localId="375" locator="155:3-155:67" name="One pneumococcal primary series dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  <operand localId="377" locator="156:9-156:69" name="The client's age is less than or equal to 5 years" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="379" locator="157:9-157:91" name="The first pneumococcal dose was administered after 24 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="381" locator="158:9-158:73" name="Client is not at high risk for pneumococcal infection" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="385" locator="165:1-169:91" name="Pneumococcal immunization schedule is complete Case 2" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Pneumococcal immunization schedule is complete Case 2"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Complete&quot;"/>
            <a:s r="385">
               <a:s>/*
@output: Pneumococcal immunization schedule is complete Case 2
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Complete&quot;
&quot;Completed the primary vaccination series&quot; = TRUE (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;)
*/
define &quot;Pneumococcal immunization schedule is complete Case 2&quot;:
  </a:s>
               <a:s r="386">
                  <a:s r="387">
                     <a:s r="388">
                        <a:s r="390">
                           <a:s r="389">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="390">
                              <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="392">
                           <a:s r="391">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="392">
                              <a:s>&quot;No pneumococcal booster dose was administered&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="394">
                        <a:s r="393">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="394">
                           <a:s>&quot;The client's age is less than or equal to 5 years&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="396">
                     <a:s r="395">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="396">
                        <a:s>&quot;The first pneumococcal dose was administered after 12 months post birth&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="386" locator="166:3-169:91" xsi:type="And">
            <operand localId="387" locator="166:3-168:69" xsi:type="And">
               <operand localId="388" locator="166:3-167:65" xsi:type="And">
                  <operand localId="390" locator="166:3-166:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  <operand localId="392" locator="167:9-167:65" name="No pneumococcal booster dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="394" locator="168:9-168:69" name="The client's age is less than or equal to 5 years" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="396" locator="169:9-169:91" name="The first pneumococcal dose was administered after 12 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="400" locator="175:1-179:92" name="Pneumococcal immunization schedule is complete Case 3" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Pneumococcal immunization schedule is complete Case 3"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Complete&quot;"/>
            <a:s r="400">
               <a:s>/*
@output: Pneumococcal immunization schedule is complete Case 3
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Complete&quot;
*/
define &quot;Pneumococcal immunization schedule is complete Case 3&quot;:
  </a:s>
               <a:s r="401">
                  <a:s r="402">
                     <a:s r="403">
                        <a:s r="405">
                           <a:s r="404">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="405">
                              <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="407">
                           <a:s r="406">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="407">
                              <a:s>&quot;One pneumococcal booster dose was administered&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="409">
                        <a:s r="408">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="409">
                           <a:s>&quot;The client's age is more than or equal to 12 months and less than 24 months&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="411">
                     <a:s r="410">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="411">
                        <a:s>&quot;The latest pneumococcal dose was administered after 12 months post birth&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="401" locator="176:3-179:92" xsi:type="And">
            <operand localId="402" locator="176:3-178:95" xsi:type="And">
               <operand localId="403" locator="176:3-177:66" xsi:type="And">
                  <operand localId="405" locator="176:3-176:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  <operand localId="407" locator="177:9-177:66" name="One pneumococcal booster dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="409" locator="178:9-178:95" name="The client's age is more than or equal to 12 months and less than 24 months" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="411" locator="179:9-179:92" name="The latest pneumococcal dose was administered after 12 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="415" locator="185:1-189:53" name="Pneumococcal immunization schedule is complete Case 4" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Pneumococcal immunization schedule is complete Case 4"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Complete&quot;"/>
            <a:s r="415">
               <a:s>/*
@output: Pneumococcal immunization schedule is complete Case 4
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Complete&quot;
*/
define &quot;Pneumococcal immunization schedule is complete Case 4&quot;:
  </a:s>
               <a:s r="416">
                  <a:s r="417">
                     <a:s r="418">
                        <a:s r="420">
                           <a:s r="419">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="420">
                              <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="422">
                           <a:s r="421">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="422">
                              <a:s>&quot;One pneumococcal booster dose was administered&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="424">
                        <a:s r="423">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="424">
                           <a:s>&quot;Client's HIV status is negative or unknown&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="426">
                     <a:s r="425">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="426">
                        <a:s>&quot;Client did not have preterm birth&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="416" locator="186:3-189:53" xsi:type="And">
            <operand localId="417" locator="186:3-188:62" xsi:type="And">
               <operand localId="418" locator="186:3-187:66" xsi:type="And">
                  <operand localId="420" locator="186:3-186:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  <operand localId="422" locator="187:9-187:66" name="One pneumococcal booster dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="424" locator="188:9-188:62" name="Client's HIV status is negative or unknown" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="426" locator="189:9-189:53" name="Client did not have preterm birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="430" locator="195:1-198:71" name="Pneumococcal immunization schedule is complete Case 5" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Pneumococcal immunization schedule is complete Case 5"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Complete&quot;"/>
            <a:s r="430">
               <a:s>/*
@output: Pneumococcal immunization schedule is complete Case 5
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Complete&quot;
*/
define &quot;Pneumococcal immunization schedule is complete Case 5&quot;:
  </a:s>
               <a:s r="431">
                  <a:s r="432">
                     <a:s r="434">
                        <a:s r="433">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="434">
                           <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="436">
                        <a:s r="435">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="436">
                           <a:s>&quot;One pneumococcal booster dose was administered&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="438">
                     <a:s r="437">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="438">
                        <a:s>&quot;The client's age is more than or equal to 24 months&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="431" locator="196:3-198:71" xsi:type="And">
            <operand localId="432" locator="196:3-197:66" xsi:type="And">
               <operand localId="434" locator="196:3-196:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
               <operand localId="436" locator="197:9-197:66" name="One pneumococcal booster dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="438" locator="198:9-198:71" name="The client's age is more than or equal to 24 months" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="442" locator="204:1-206:68" name="Pneumococcal immunization schedule is complete Case 6" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Pneumococcal immunization schedule is complete Case 6"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Complete&quot;"/>
            <a:s r="442">
               <a:s>/*
@output: Pneumococcal immunization schedule is complete Case 6
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Complete&quot;
*/
define &quot;Pneumococcal immunization schedule is complete Case 6&quot;:
  </a:s>
               <a:s r="443">
                  <a:s r="445">
                     <a:s r="444">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="445">
                        <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="447">
                     <a:s r="446">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="447">
                        <a:s>&quot;Two pneumococcal booster doses were administered&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="443" locator="205:3-206:68" xsi:type="And">
            <operand localId="445" locator="205:3-205:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
            <operand localId="447" locator="206:9-206:68" name="Two pneumococcal booster doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="362" locator="213:1-219:62" name="Pneumococcal immunization schedule is complete" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Pneumococcal immunization schedule is complete"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Complete&quot;"/>
            <a:s r="362">
               <a:s>/*
@output: Pneumococcal immunization schedule is complete
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Complete&quot;
&quot;Completed the primary vaccination series&quot; = TRUE (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;)
*/
define &quot;Pneumococcal immunization schedule is complete&quot;:
  </a:s>
               <a:s r="363">
                  <a:s r="364">
                     <a:s r="365">
                        <a:s r="366">
                           <a:s r="367">
                              <a:s r="382">
                                 <a:s>&quot;Pneumococcal immunization schedule is complete Case 1&quot;</a:s>
                              </a:s>
                              <a:s>
    or </a:s>
                              <a:s r="397">
                                 <a:s>&quot;Pneumococcal immunization schedule is complete Case 2&quot;</a:s>
                              </a:s>
                           </a:s>
                           <a:s>
    or </a:s>
                           <a:s r="412">
                              <a:s>&quot;Pneumococcal immunization schedule is complete Case 3&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    or </a:s>
                        <a:s r="427">
                           <a:s>&quot;Pneumococcal immunization schedule is complete Case 4&quot;</a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    or </a:s>
                     <a:s r="439">
                        <a:s>&quot;Pneumococcal immunization schedule is complete Case 5&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    or </a:s>
                  <a:s r="448">
                     <a:s>&quot;Pneumococcal immunization schedule is complete Case 6&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="363" locator="214:3-219:62" xsi:type="Or">
            <operand localId="364" locator="214:3-218:62" xsi:type="Or">
               <operand localId="365" locator="214:3-217:62" xsi:type="Or">
                  <operand localId="366" locator="214:3-216:62" xsi:type="Or">
                     <operand localId="367" locator="214:3-215:62" xsi:type="Or">
                        <operand localId="382" locator="214:3-214:57" name="Pneumococcal immunization schedule is complete Case 1" xsi:type="ExpressionRef"/>
                        <operand localId="397" locator="215:8-215:62" name="Pneumococcal immunization schedule is complete Case 2" xsi:type="ExpressionRef"/>
                     </operand>
                     <operand localId="412" locator="216:8-216:62" name="Pneumococcal immunization schedule is complete Case 3" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="427" locator="217:8-217:62" name="Pneumococcal immunization schedule is complete Case 4" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="439" locator="218:8-218:62" name="Pneumococcal immunization schedule is complete Case 5" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="448" locator="219:8-219:62" name="Pneumococcal immunization schedule is complete Case 6" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="452" locator="236:1-251:5" name="Pneumococcal immunization schedule is complete Guidance" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Pneumococcal immunization schedule is complete Guidance"/>
            <a:s r="452">
               <a:s>/*
@output: Pneumococcal immunization schedule is complete Guidance
@guidance = Pneumococcal immunization schedule is complete. One primary series dose was administered. 
Check for any other vaccines due.
@guidance = Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses were administered. 
Check for any other vaccines due.
@guidance = Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.
Check for any other vaccines due.
@guidance = Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.
Check for any other vaccines due.
@guidance = Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.
Check for any other vaccines due.
@guidance = Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and two booster doses were administered. 
Check for any other vaccines due.
*/
define &quot;Pneumococcal immunization schedule is complete Guidance&quot;:
  </a:s>
               <a:s r="453">
                  <a:s>case
    </a:s>
                  <a:s r="454">
                     <a:s>when </a:s>
                     <a:s r="455">
                        <a:s>&quot;Pneumococcal immunization schedule is complete Case 1&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="456">
                        <a:s>'Pneumococcal immunization schedule is complete. One primary series dose was administered. 
Check for any other vaccines due.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="458">
                     <a:s>when </a:s>
                     <a:s r="459">
                        <a:s>&quot;Pneumococcal immunization schedule is complete Case 2&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="460">
                        <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses were administered. 
Check for any other vaccines due.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="462">
                     <a:s>when </a:s>
                     <a:s r="463">
                        <a:s>&quot;Pneumococcal immunization schedule is complete Case 3&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="464">
                        <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.
Check for any other vaccines due.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="466">
                     <a:s>when </a:s>
                     <a:s r="467">
                        <a:s>&quot;Pneumococcal immunization schedule is complete Case 4&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="468">
                        <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.
Check for any other vaccines due.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="470">
                     <a:s>when </a:s>
                     <a:s r="471">
                        <a:s>&quot;Pneumococcal immunization schedule is complete Case 5&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="472">
                        <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.
Check for any other vaccines due.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="474">
                     <a:s>when </a:s>
                     <a:s r="475">
                        <a:s>&quot;Pneumococcal immunization schedule is complete Case 6&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="476">
                        <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and two booster doses were administered. 
Check for any other vaccines due.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    else </a:s>
                  <a:s r="478">
                     <a:s>''</a:s>
                  </a:s>
                  <a:s>
  end</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="453" locator="237:3-251:5" xsi:type="Case">
            <caseItem localId="454" locator="238:5-238:196">
               <when localId="455" locator="238:10-238:64" name="Pneumococcal immunization schedule is complete Case 1" xsi:type="ExpressionRef"/>
               <then localId="456" locator="238:71-238:196" valueType="t:String" value="Pneumococcal immunization schedule is complete. One primary series dose was administered. &#xa;Check for any other vaccines due." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="458" locator="240:5-240:211">
               <when localId="459" locator="240:10-240:64" name="Pneumococcal immunization schedule is complete Case 2" xsi:type="ExpressionRef"/>
               <then localId="460" locator="240:71-240:211" valueType="t:String" value="Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses were administered. &#xa;Check for any other vaccines due." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="462" locator="242:5-242:231">
               <when localId="463" locator="242:10-242:64" name="Pneumococcal immunization schedule is complete Case 3" xsi:type="ExpressionRef"/>
               <then localId="464" locator="242:71-242:231" valueType="t:String" value="Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.&#xa;Check for any other vaccines due." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="466" locator="244:5-244:231">
               <when localId="467" locator="244:10-244:64" name="Pneumococcal immunization schedule is complete Case 4" xsi:type="ExpressionRef"/>
               <then localId="468" locator="244:71-244:231" valueType="t:String" value="Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.&#xa;Check for any other vaccines due." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="470" locator="246:5-246:231">
               <when localId="471" locator="246:10-246:64" name="Pneumococcal immunization schedule is complete Case 5" xsi:type="ExpressionRef"/>
               <then localId="472" locator="246:71-246:231" valueType="t:String" value="Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.&#xa;Check for any other vaccines due." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="474" locator="248:5-248:233">
               <when localId="475" locator="248:10-248:64" name="Pneumococcal immunization schedule is complete Case 6" xsi:type="ExpressionRef"/>
               <then localId="476" locator="248:71-248:233" valueType="t:String" value="Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and two booster doses were administered. &#xa;Check for any other vaccines due." xsi:type="Literal"/>
            </caseItem>
            <else localId="478" locator="250:10-250:11" valueType="t:String" value="" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="489" locator="257:1-261:92" name="Client is due for pneumococcal booster dose Case 1" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal booster dose Case 1"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Due&quot;"/>
            <a:s r="489">
               <a:s>/*
@output: Client is due for pneumococcal booster dose Case 1
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for pneumococcal booster dose Case 1&quot;:
  </a:s>
               <a:s r="490">
                  <a:s r="491">
                     <a:s r="492">
                        <a:s r="494">
                           <a:s r="493">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="494">
                              <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="496">
                           <a:s r="495">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="496">
                              <a:s>&quot;No pneumococcal booster dose was administered&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="498">
                        <a:s r="497">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="498">
                           <a:s>&quot;The client's age is less than or equal to 5 years&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="500">
                     <a:s r="499">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="500">
                        <a:s>&quot;The first pneumococcal dose was administered within 12 months post birth&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="490" locator="258:3-261:92" xsi:type="And">
            <operand localId="491" locator="258:3-260:69" xsi:type="And">
               <operand localId="492" locator="258:3-259:65" xsi:type="And">
                  <operand localId="494" locator="258:3-258:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  <operand localId="496" locator="259:9-259:65" name="No pneumococcal booster dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="498" locator="260:9-260:69" name="The client's age is less than or equal to 5 years" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="500" locator="261:9-261:92" name="The first pneumococcal dose was administered within 12 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="504" locator="267:1-272:51" name="Client is due for pneumococcal booster dose Case 2" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal booster dose Case 2"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Due&quot;"/>
            <a:s r="504">
               <a:s>/*
@output: Client is due for pneumococcal booster dose Case 2
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for pneumococcal booster dose Case 2&quot;:
  </a:s>
               <a:s r="505">
                  <a:s r="506">
                     <a:s r="507">
                        <a:s r="508">
                           <a:s r="510">
                              <a:s r="509">
                                 <a:s>Encounter</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="510">
                                 <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                              </a:s>
                           </a:s>
                           <a:s>
    and </a:s>
                           <a:s r="512">
                              <a:s r="511">
                                 <a:s>Encounter</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="512">
                                 <a:s>&quot;One pneumococcal booster dose was administered&quot;</a:s>
                              </a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="514">
                           <a:s r="513">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="514">
                              <a:s>&quot;The client's age is more than or equal to 12 months and less than 24 months&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="516">
                        <a:s r="515">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="516">
                           <a:s>&quot;The latest pneumococcal dose was administered within 12 months post birth&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="518">
                     <a:s r="517">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="518">
                        <a:s>&quot;Client's HIV status is positive&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="505" locator="268:3-272:51" xsi:type="And">
            <operand localId="506" locator="268:3-271:93" xsi:type="And">
               <operand localId="507" locator="268:3-270:95" xsi:type="And">
                  <operand localId="508" locator="268:3-269:66" xsi:type="And">
                     <operand localId="510" locator="268:3-268:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                     <operand localId="512" locator="269:9-269:66" name="One pneumococcal booster dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="514" locator="270:9-270:95" name="The client's age is more than or equal to 12 months and less than 24 months" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="516" locator="271:9-271:93" name="The latest pneumococcal dose was administered within 12 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="518" locator="272:9-272:51" name="Client's HIV status is positive" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="522" locator="278:1-283:44" name="Client is due for pneumococcal booster dose Case 3" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal booster dose Case 3"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Due&quot;"/>
            <a:s r="522">
               <a:s>/*
@output: Client is due for pneumococcal booster dose Case 3
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for pneumococcal booster dose Case 3&quot;:
  </a:s>
               <a:s r="523">
                  <a:s r="524">
                     <a:s r="525">
                        <a:s r="526">
                           <a:s r="528">
                              <a:s r="527">
                                 <a:s>Encounter</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="528">
                                 <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                              </a:s>
                           </a:s>
                           <a:s>
    and </a:s>
                           <a:s r="530">
                              <a:s r="529">
                                 <a:s>Encounter</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="530">
                                 <a:s>&quot;One pneumococcal booster dose was administered&quot;</a:s>
                              </a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="532">
                           <a:s r="531">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="532">
                              <a:s>&quot;The client's age is more than or equal to 12 months and less than 24 months&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="534">
                        <a:s r="533">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="534">
                           <a:s>&quot;The latest pneumococcal dose was administered within 12 months post birth&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="536">
                     <a:s r="535">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="536">
                        <a:s>&quot;Client had preterm birth&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="523" locator="279:3-283:44" xsi:type="And">
            <operand localId="524" locator="279:3-282:93" xsi:type="And">
               <operand localId="525" locator="279:3-281:95" xsi:type="And">
                  <operand localId="526" locator="279:3-280:66" xsi:type="And">
                     <operand localId="528" locator="279:3-279:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                     <operand localId="530" locator="280:9-280:66" name="One pneumococcal booster dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="532" locator="281:9-281:95" name="The client's age is more than or equal to 12 months and less than 24 months" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="534" locator="282:9-282:93" name="The latest pneumococcal dose was administered within 12 months post birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="536" locator="283:9-283:44" name="Client had preterm birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="484" locator="289:1-292:59" name="Client is due for pneumococcal booster dose" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal booster dose"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Due&quot;"/>
            <a:s r="484">
               <a:s>/*
@output: Client is due for pneumococcal booster dose
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for pneumococcal booster dose&quot;:
  </a:s>
               <a:s r="485">
                  <a:s r="486">
                     <a:s r="501">
                        <a:s>&quot;Client is due for pneumococcal booster dose Case 1&quot;</a:s>
                     </a:s>
                     <a:s>
    or </a:s>
                     <a:s r="519">
                        <a:s>&quot;Client is due for pneumococcal booster dose Case 2&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    or </a:s>
                  <a:s r="537">
                     <a:s>&quot;Client is due for pneumococcal booster dose Case 3&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="485" locator="290:3-292:59" xsi:type="Or">
            <operand localId="486" locator="290:3-291:59" xsi:type="Or">
               <operand localId="501" locator="290:3-290:54" name="Client is due for pneumococcal booster dose Case 1" xsi:type="ExpressionRef"/>
               <operand localId="519" locator="291:8-291:59" name="Client is due for pneumococcal booster dose Case 2" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="537" locator="292:8-292:59" name="Client is due for pneumococcal booster dose Case 3" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="541" locator="303:1-312:5" name="Client is due for pneumococcal booster dose Guidance" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is due for pneumococcal booster dose Guidance"/>
            <a:s r="541">
               <a:s>/*
@output: Client is due for pneumococcal booster dose Guidance
@guidance = Should vaccinate client with first pneumococcal booster dose as first pneumococcal dose was administered within 12 months post birth. 
Check for contraindications.
@guidance = Should vaccinate client with second pneumococcal booster dose as client is HIV positive and latest pneumococcal dose was administered within 12 months post birth.
Check for contraindications.
@guidance = Should vaccinate client with second pneumococcal booster dose as client had preterm birth and latest pneumococcal dose was administered within 12 months post birth.
Check for contraindications.
*/
define &quot;Client is due for pneumococcal booster dose Guidance&quot;:
  </a:s>
               <a:s r="542">
                  <a:s>case
    </a:s>
                  <a:s r="543">
                     <a:s>when </a:s>
                     <a:s r="544">
                        <a:s>&quot;Client is due for pneumococcal booster dose Case 1&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="545">
                        <a:s>'Should vaccinate client with first pneumococcal booster dose as first pneumococcal dose was administered within 12 months post birth. 
Check for contraindications.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="547">
                     <a:s>when </a:s>
                     <a:s r="548">
                        <a:s>&quot;Client is due for pneumococcal booster dose Case 2&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="549">
                        <a:s>'Should vaccinate client with second pneumococcal booster dose as client is HIV positive and latest pneumococcal dose was administered within 12 months post birth.
Check for contraindications.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="551">
                     <a:s>when </a:s>
                     <a:s r="552">
                        <a:s>&quot;Client is due for pneumococcal booster dose Case 3&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="553">
                        <a:s>'Should vaccinate client with second pneumococcal booster dose as client had preterm birth and latest pneumococcal dose was administered within 12 months post birth.
Check for contraindications.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    else </a:s>
                  <a:s r="555">
                     <a:s>''</a:s>
                  </a:s>
                  <a:s>
  end</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="542" locator="304:3-312:5" xsi:type="Case">
            <caseItem localId="543" locator="305:5-305:232">
               <when localId="544" locator="305:10-305:61" name="Client is due for pneumococcal booster dose Case 1" xsi:type="ExpressionRef"/>
               <then localId="545" locator="305:68-305:232" valueType="t:String" value="Should vaccinate client with first pneumococcal booster dose as first pneumococcal dose was administered within 12 months post birth. &#xa;Check for contraindications." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="547" locator="307:5-307:260">
               <when localId="548" locator="307:10-307:61" name="Client is due for pneumococcal booster dose Case 2" xsi:type="ExpressionRef"/>
               <then localId="549" locator="307:68-307:260" valueType="t:String" value="Should vaccinate client with second pneumococcal booster dose as client is HIV positive and latest pneumococcal dose was administered within 12 months post birth.&#xa;Check for contraindications." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="551" locator="309:5-309:262">
               <when localId="552" locator="309:10-309:61" name="Client is due for pneumococcal booster dose Case 3" xsi:type="ExpressionRef"/>
               <then localId="553" locator="309:68-309:262" valueType="t:String" value="Should vaccinate client with second pneumococcal booster dose as client had preterm birth and latest pneumococcal dose was administered within 12 months post birth.&#xa;Check for contraindications." xsi:type="Literal"/>
            </caseItem>
            <else localId="555" locator="311:10-311:11" valueType="t:String" value="" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="565" locator="318:1-322:51" name="Client is not due for pneumococcal booster dose Case 1" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is not due for pneumococcal booster dose Case 1"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Not due&quot;"/>
            <a:s r="565">
               <a:s>/*
@output: Client is not due for pneumococcal booster dose Case 1
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for pneumococcal booster dose Case 1&quot;:
  </a:s>
               <a:s r="566">
                  <a:s r="567">
                     <a:s r="568">
                        <a:s r="570">
                           <a:s r="569">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="570">
                              <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="572">
                           <a:s r="571">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="572">
                              <a:s>&quot;One pneumococcal booster dose was administered&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="574">
                        <a:s r="573">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="574">
                           <a:s>&quot;The client's age is less than 12 months&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="576">
                     <a:s r="575">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="576">
                        <a:s>&quot;Client's HIV status is positive&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="566" locator="319:3-322:51" xsi:type="And">
            <operand localId="567" locator="319:3-321:59" xsi:type="And">
               <operand localId="568" locator="319:3-320:66" xsi:type="And">
                  <operand localId="570" locator="319:3-319:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  <operand localId="572" locator="320:9-320:66" name="One pneumococcal booster dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="574" locator="321:9-321:59" name="The client's age is less than 12 months" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="576" locator="322:9-322:51" name="Client's HIV status is positive" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="580" locator="328:1-332:44" name="Client is not due for pneumococcal booster dose Case 2" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is not due for pneumococcal booster dose Case 2"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Not due&quot;"/>
            <a:s r="580">
               <a:s>/*
@output: Client is not due for pneumococcal booster dose Case 2
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for pneumococcal booster dose Case 2&quot;:
  </a:s>
               <a:s r="581">
                  <a:s r="582">
                     <a:s r="583">
                        <a:s r="585">
                           <a:s r="584">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="585">
                              <a:s>&quot;Two pneumococcal primary series doses were administered&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s>
    and </a:s>
                        <a:s r="587">
                           <a:s r="586">
                              <a:s>Encounter</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="587">
                              <a:s>&quot;One pneumococcal booster dose was administered&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                     <a:s>
    and </a:s>
                     <a:s r="589">
                        <a:s r="588">
                           <a:s>Encounter</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="589">
                           <a:s>&quot;The client's age is less than 12 months&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="591">
                     <a:s r="590">
                        <a:s>Encounter</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="591">
                        <a:s>&quot;Client had preterm birth&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="581" locator="329:3-332:44" xsi:type="And">
            <operand localId="582" locator="329:3-331:59" xsi:type="And">
               <operand localId="583" locator="329:3-330:66" xsi:type="And">
                  <operand localId="585" locator="329:3-329:69" name="Two pneumococcal primary series doses were administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
                  <operand localId="587" locator="330:9-330:66" name="One pneumococcal booster dose was administered" libraryName="Encounter" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="589" locator="331:9-331:59" name="The client's age is less than 12 months" libraryName="Encounter" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="591" locator="332:9-332:44" name="Client had preterm birth" libraryName="Encounter" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="561" locator="338:1-340:63" name="Client is not due for pneumococcal booster dose" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is not due for pneumococcal booster dose"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Not due&quot;"/>
            <a:s r="561">
               <a:s>/*
@output: Client is not due for pneumococcal booster dose
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for pneumococcal booster dose&quot;:
  </a:s>
               <a:s r="562">
                  <a:s r="577">
                     <a:s>&quot;Client is not due for pneumococcal booster dose Case 1&quot;</a:s>
                  </a:s>
                  <a:s>
    or </a:s>
                  <a:s r="592">
                     <a:s>&quot;Client is not due for pneumococcal booster dose Case 2&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="562" locator="339:3-340:63" xsi:type="Or">
            <operand localId="577" locator="339:3-339:58" name="Client is not due for pneumococcal booster dose Case 1" xsi:type="ExpressionRef"/>
            <operand localId="592" locator="340:8-340:63" name="Client is not due for pneumococcal booster dose Case 2" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="596" locator="349:1-356:5" name="Client is not due for pneumococcal booster dose Guidance" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Client is not due for pneumococcal booster dose Guidance"/>
            <a:s r="596">
               <a:s>/*
@output: Client is not due for pneumococcal booster dose Guidance
@guidance = Should not vaccinate client with second pneumococcal booster dose as client's age is less than 12 months and client is HIV positive. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.
@guidance = Should not vaccinate client with second pneumococcal booster dose as client's age is less than 12 months and client had preterm birth. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.
*/
define &quot;Client is not due for pneumococcal booster dose Guidance&quot;:
  </a:s>
               <a:s r="597">
                  <a:s>case
    </a:s>
                  <a:s r="598">
                     <a:s>when </a:s>
                     <a:s r="599">
                        <a:s>&quot;Client is not due for pneumococcal booster dose Case 1&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="600">
                        <a:s>'Should not vaccinate client with second pneumococcal booster dose as client\'s age is less than 12 months and client is HIV positive. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="602">
                     <a:s>when </a:s>
                     <a:s r="603">
                        <a:s>&quot;Client is not due for pneumococcal booster dose Case 2&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="604">
                        <a:s>'Should not vaccinate client with second pneumococcal booster dose as client\'s age is less than 12 months and client had preterm birth. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.'</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    else </a:s>
                  <a:s r="606">
                     <a:s>''</a:s>
                  </a:s>
                  <a:s>
  end</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="597" locator="350:3-356:5" xsi:type="Case">
            <caseItem localId="598" locator="351:5-351:305">
               <when localId="599" locator="351:10-351:65" name="Client is not due for pneumococcal booster dose Case 1" xsi:type="ExpressionRef"/>
               <then localId="600" locator="351:72-351:305" valueType="t:String" value="Should not vaccinate client with second pneumococcal booster dose as client's age is less than 12 months and client is HIV positive. &#xa;Check for any other vaccines due and inform the caregiver of when to come back for the next dose." xsi:type="Literal"/>
            </caseItem>
            <caseItem localId="602" locator="353:5-353:307">
               <when localId="603" locator="353:10-353:65" name="Client is not due for pneumococcal booster dose Case 2" xsi:type="ExpressionRef"/>
               <then localId="604" locator="353:72-353:307" valueType="t:String" value="Should not vaccinate client with second pneumococcal booster dose as client's age is less than 12 months and client had preterm birth. &#xa;Check for any other vaccines due and inform the caregiver of when to come back for the next dose." xsi:type="Literal"/>
            </caseItem>
            <else localId="606" locator="355:10-355:11" valueType="t:String" value="" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="612" locator="362:1-363:51" name="Clinical judgement is required. Create a clinical note" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Clinical judgement is required. Create a clinical note"/>
            <a:t name="pseudocode" value="&quot;Immunization recommendation status&quot; = &quot;Further evaluation needed&quot;"/>
            <a:s r="612">
               <a:s>/*
@output: Clinical judgement is required. Create a clinical note
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Further evaluation needed&quot;
*/
define &quot;Clinical judgement is required. Create a clinical note&quot;:
  </a:s>
               <a:s r="614">
                  <a:s r="613">
                     <a:s>Encounter</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="614">
                     <a:s>&quot;The client's age is more than 5 years&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="614" locator="363:3-363:51" name="The client's age is more than 5 years" libraryName="Encounter" xsi:type="ExpressionRef"/>
      </def>
      <def localId="618" locator="369:1-370:94" name="Clinical judgement is required. Create a clinical note Guidance" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="output" value="Clinical judgement is required. Create a clinical note Guidance"/>
            <a:t name="guidance" value="Members States should update this action according to the national immunization programme."/>
            <a:s r="618">
               <a:s>/*
@output: Clinical judgement is required. Create a clinical note Guidance
@guidance: Members States should update this action according to the national immunization programme.
*/
define &quot;Clinical judgement is required. Create a clinical note Guidance&quot;:
  </a:s>
               <a:s r="619">
                  <a:s>'Members States should update this action according to the national immunization programme.'</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="619" locator="370:3-370:94" valueType="t:String" value="Members States should update this action according to the national immunization programme." xsi:type="Literal"/>
      </def>
      <def localId="224" locator="22:1-31:5" name="Guidance" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="dynamicValue" value="Guidance"/>
            <a:s r="224">
               <a:s>/*
@dynamicValue: Guidance
*/
define &quot;Guidance&quot;:
  </a:s>
               <a:s r="225">
                  <a:s>case 
    </a:s>
                  <a:s r="226">
                     <a:s>when </a:s>
                     <a:s r="271">
                        <a:s>&quot;Client is not due for pneumococcal vaccination&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="290">
                        <a:s>&quot;Client is not due for pneumococcal vaccination Guidance&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="291">
                     <a:s>when </a:s>
                     <a:s r="339">
                        <a:s>&quot;Client is due for pneumococcal vaccination&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="358">
                        <a:s>&quot;Client is due for pneumococcal vaccination Guidance&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="359">
                     <a:s>when </a:s>
                     <a:s r="449">
                        <a:s>&quot;Pneumococcal immunization schedule is complete&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="480">
                        <a:s>&quot;Pneumococcal immunization schedule is complete Guidance&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="481">
                     <a:s>when </a:s>
                     <a:s r="538">
                        <a:s>&quot;Client is due for pneumococcal booster dose&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="557">
                        <a:s>&quot;Client is due for pneumococcal booster dose Guidance&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="558">
                     <a:s>when </a:s>
                     <a:s r="593">
                        <a:s>&quot;Client is not due for pneumococcal booster dose&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="608">
                        <a:s>&quot;Client is not due for pneumococcal booster dose Guidance&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="609">
                     <a:s>when </a:s>
                     <a:s r="615">
                        <a:s>&quot;Clinical judgement is required. Create a clinical note&quot;</a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="621">
                        <a:s>&quot;Clinical judgement is required. Create a clinical note Guidance&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s> 
    else </a:s>
                  <a:s r="622">
                     <a:s>''</a:s>
                  </a:s>
                  <a:s>
  end</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="225" locator="23:3-31:5" xsi:type="Case">
            <caseItem localId="226" locator="24:5-24:120">
               <when localId="271" locator="24:10-24:57" name="Client is not due for pneumococcal vaccination" xsi:type="ExpressionRef"/>
               <then localId="290" locator="24:64-24:120" name="Client is not due for pneumococcal vaccination Guidance" xsi:type="ExpressionRef"/>
            </caseItem>
            <caseItem localId="291" locator="25:5-25:112">
               <when localId="339" locator="25:10-25:53" name="Client is due for pneumococcal vaccination" xsi:type="ExpressionRef"/>
               <then localId="358" locator="25:60-25:112" name="Client is due for pneumococcal vaccination Guidance" xsi:type="ExpressionRef"/>
            </caseItem>
            <caseItem localId="359" locator="26:5-26:120">
               <when localId="449" locator="26:10-26:57" name="Pneumococcal immunization schedule is complete" xsi:type="ExpressionRef"/>
               <then localId="480" locator="26:64-26:120" name="Pneumococcal immunization schedule is complete Guidance" xsi:type="ExpressionRef"/>
            </caseItem>
            <caseItem localId="481" locator="27:5-27:114">
               <when localId="538" locator="27:10-27:54" name="Client is due for pneumococcal booster dose" xsi:type="ExpressionRef"/>
               <then localId="557" locator="27:61-27:114" name="Client is due for pneumococcal booster dose Guidance" xsi:type="ExpressionRef"/>
            </caseItem>
            <caseItem localId="558" locator="28:5-28:122">
               <when localId="593" locator="28:10-28:58" name="Client is not due for pneumococcal booster dose" xsi:type="ExpressionRef"/>
               <then localId="608" locator="28:65-28:122" name="Client is not due for pneumococcal booster dose Guidance" xsi:type="ExpressionRef"/>
            </caseItem>
            <caseItem localId="609" locator="29:5-29:136">
               <when localId="615" locator="29:10-29:65" name="Clinical judgement is required. Create a clinical note" xsi:type="ExpressionRef"/>
               <then localId="621" locator="29:72-29:136" name="Clinical judgement is required. Create a clinical note Guidance" xsi:type="ExpressionRef"/>
            </caseItem>
            <else localId="622" locator="30:10-30:11" valueType="t:String" value="" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="626" locator="33:1-34:45" name="Has Guidance" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:s r="626">
               <a:s>define &quot;Has Guidance&quot;:
  </a:s>
               <a:s r="627">
                  <a:s r="630">
                     <a:s r="628">
                        <a:s>&quot;Guidance&quot;</a:s>
                     </a:s>
                     <a:s> is not null</a:s>
                  </a:s>
                  <a:s> and </a:s>
                  <a:s r="637">
                     <a:s r="632">
                        <a:s>&quot;Guidance&quot;</a:s>
                     </a:s>
                     <a:s> != </a:s>
                     <a:s r="633">
                        <a:s>''</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="627" locator="34:3-34:45" xsi:type="And">
            <operand localId="630" locator="34:3-34:24" xsi:type="Not">
               <operand localId="629" locator="34:3-34:24" xsi:type="IsNull">
                  <operand localId="628" locator="34:3-34:12" name="Guidance" xsi:type="ExpressionRef"/>
               </operand>
            </operand>
            <operand localId="637" locator="34:30-34:45" xsi:type="Not">
               <operand localId="631" locator="34:30-34:45" xsi:type="Equal">
                  <signature localId="635" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="636" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="632" locator="34:30-34:39" name="Guidance" xsi:type="ExpressionRef"/>
                  <operand localId="633" locator="34:44-34:45" valueType="t:String" value="" xsi:type="Literal"/>
               </operand>
            </operand>
         </expression>
      </def>
      <def localId="640" locator="376:1-413:5" name="Test Validation" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="test" value="Test expected results based on example patients"/>
            <a:s r="640">
               <a:s>/*
@test: Test expected results based on example patients
*/
define &quot;Test Validation&quot;:
  </a:s>
               <a:s r="641">
                  <a:s>case
    </a:s>
                  <a:s r="642">
                     <a:s>when </a:s>
                     <a:s r="643">
                        <a:s r="645">
                           <a:s r="644">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="645">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="646">
                           <a:s>'Pneumococcal08.1'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="652">
                        <a:s r="653">
                           <a:s>&quot;Client is not due for pneumococcal vaccination Case 1&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="654">
                           <a:s r="655">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="656">
                              <a:s>'Should not vaccinate client with first pneumococcal dose as client\'s age is less than 6 weeks. Check for any vaccines due and inform the caregiver of when to come back for the first dose.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="660">
                     <a:s>when </a:s>
                     <a:s r="661">
                        <a:s r="663">
                           <a:s r="662">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="663">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="664">
                           <a:s>'Pneumococcal09.2'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="670">
                        <a:s r="671">
                           <a:s>&quot;Client is due for pneumococcal vaccination Case 1&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="672">
                           <a:s r="673">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="674">
                              <a:s>'Should vaccinate client with first pneumococcal dose as no pneumococcal doses were administered and client is within the appropriate age range.
Check for contraindications.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="678">
                     <a:s>when </a:s>
                     <a:s r="679">
                        <a:s r="681">
                           <a:s r="680">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="681">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="682">
                           <a:s>'Pneumococcal10.4'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="688">
                        <a:s r="689">
                           <a:s>&quot;Client is not due for pneumococcal vaccination Case 2&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="690">
                           <a:s r="691">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="692">
                              <a:s>'Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="696">
                     <a:s>when </a:s>
                     <a:s r="697">
                        <a:s r="699">
                           <a:s r="698">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="699">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="700">
                           <a:s>'Pneumococcal11.4'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="706">
                        <a:s r="707">
                           <a:s>&quot;Client is due for pneumococcal vaccination Case 2&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="708">
                           <a:s r="709">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="710">
                              <a:s>'Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago. 
Check for contraindications.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="714">
                     <a:s>when </a:s>
                     <a:s r="715">
                        <a:s r="717">
                           <a:s r="716">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="717">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="718">
                           <a:s>'Pneumococcal12.5'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="724">
                        <a:s r="725">
                           <a:s>&quot;Client is not due for pneumococcal vaccination Case 3&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="726">
                           <a:s r="727">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="728">
                              <a:s>'Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago and client is at high risk for pneumococcal infection. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="732">
                     <a:s>when </a:s>
                     <a:s r="733">
                        <a:s r="735">
                           <a:s r="734">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="735">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="736">
                           <a:s>'Pneumococcal13.5'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="742">
                        <a:s r="743">
                           <a:s>&quot;Client is due for pneumococcal vaccination Case 3&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="744">
                           <a:s r="745">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="746">
                              <a:s>'Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago and client is at high risk for pneumococcal infection. 
Check for contraindications.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="750">
                     <a:s>when </a:s>
                     <a:s r="751">
                        <a:s r="753">
                           <a:s r="752">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="753">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="754">
                           <a:s>'Pneumococcal14.4'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="760">
                        <a:s r="761">
                           <a:s>&quot;Pneumococcal immunization schedule is complete Case 1&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="762">
                           <a:s r="763">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="764">
                              <a:s>'Pneumococcal immunization schedule is complete. One primary series dose was administered. 
Check for any other vaccines due.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="768">
                     <a:s>when </a:s>
                     <a:s r="769">
                        <a:s r="771">
                           <a:s r="770">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="771">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="772">
                           <a:s>'Pneumococcal15.4'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="778">
                        <a:s r="779">
                           <a:s>&quot;Client is due for pneumococcal booster dose Case 1&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="780">
                           <a:s r="781">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="782">
                              <a:s>'Should vaccinate client with first pneumococcal booster dose as first pneumococcal dose was administered within 12 months post birth. 
Check for contraindications.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="786">
                     <a:s>when </a:s>
                     <a:s r="787">
                        <a:s r="789">
                           <a:s r="788">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="789">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="790">
                           <a:s>'Pneumococcal16.4'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="796">
                        <a:s r="797">
                           <a:s>&quot;Pneumococcal immunization schedule is complete Case 2&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="798">
                           <a:s r="799">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="800">
                              <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses were administered. 
Check for any other vaccines due.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="804">
                     <a:s>when </a:s>
                     <a:s r="805">
                        <a:s r="807">
                           <a:s r="806">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="807">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="808">
                           <a:s>'Pneumococcal17.4'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="814">
                        <a:s r="815">
                           <a:s>&quot;Client is not due for pneumococcal booster dose Case 1&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="816">
                           <a:s r="817">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="818">
                              <a:s>'Should not vaccinate client with second pneumococcal booster dose as client\'s age is less than 12 months and client is HIV positive. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="822">
                     <a:s>when </a:s>
                     <a:s r="823">
                        <a:s r="825">
                           <a:s r="824">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="825">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="826">
                           <a:s>'Pneumococcal18.4'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="832">
                        <a:s r="833">
                           <a:s>&quot;Client is not due for pneumococcal booster dose Case 2&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="834">
                           <a:s r="835">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="836">
                              <a:s>'Should not vaccinate client with second pneumococcal booster dose as client\'s age is less than 12 months and client had preterm birth. 
Check for any other vaccines due and inform the caregiver of when to come back for the next dose.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="840">
                     <a:s>when </a:s>
                     <a:s r="841">
                        <a:s r="843">
                           <a:s r="842">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="843">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="844">
                           <a:s>'Pneumococcal19.5'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="850">
                        <a:s r="851">
                           <a:s>&quot;Client is due for pneumococcal booster dose Case 2&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="852">
                           <a:s r="853">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="854">
                              <a:s>'Should vaccinate client with second pneumococcal booster dose as client is HIV positive and latest pneumococcal dose was administered within 12 months post birth.
Check for contraindications.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="858">
                     <a:s>when </a:s>
                     <a:s r="859">
                        <a:s r="861">
                           <a:s r="860">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="861">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="862">
                           <a:s>'Pneumococcal20.5'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="868">
                        <a:s r="869">
                           <a:s>&quot;Client is due for pneumococcal booster dose Case 3&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="870">
                           <a:s r="871">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="872">
                              <a:s>'Should vaccinate client with second pneumococcal booster dose as client had preterm birth and latest pneumococcal dose was administered within 12 months post birth.
Check for contraindications.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="876">
                     <a:s>when </a:s>
                     <a:s r="877">
                        <a:s r="879">
                           <a:s r="878">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="879">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="880">
                           <a:s>'Pneumococcal21.4'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="886">
                        <a:s r="887">
                           <a:s>&quot;Pneumococcal immunization schedule is complete Case 3&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="888">
                           <a:s r="889">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="890">
                              <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.
Check for any other vaccines due.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="894">
                     <a:s>when </a:s>
                     <a:s r="895">
                        <a:s r="897">
                           <a:s r="896">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="897">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="898">
                           <a:s>'Pneumococcal22.4'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="904">
                        <a:s r="905">
                           <a:s>&quot;Pneumococcal immunization schedule is complete Case 4&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="906">
                           <a:s r="907">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="908">
                              <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.
Check for any other vaccines due.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="912">
                     <a:s>when </a:s>
                     <a:s r="913">
                        <a:s r="915">
                           <a:s r="914">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="915">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="916">
                           <a:s>'Pneumococcal23.3'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="922">
                        <a:s r="923">
                           <a:s>&quot;Pneumococcal immunization schedule is complete Case 5&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="924">
                           <a:s r="925">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="926">
                              <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and one booster dose were administered.
Check for any other vaccines due.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="930">
                     <a:s>when </a:s>
                     <a:s r="931">
                        <a:s r="933">
                           <a:s r="932">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="933">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="934">
                           <a:s>'Pneumococcal24.2'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="940">
                        <a:s r="941">
                           <a:s>&quot;Pneumococcal immunization schedule is complete Case 6&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="942">
                           <a:s r="943">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="944">
                              <a:s>'Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses and two booster doses were administered. 
Check for any other vaccines due.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    </a:s>
                  <a:s r="948">
                     <a:s>when </a:s>
                     <a:s r="949">
                        <a:s r="951">
                           <a:s r="950">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="951">
                              <a:s>id</a:s>
                           </a:s>
                        </a:s>
                        <a:s> = </a:s>
                        <a:s r="952">
                           <a:s>'Pneumococcal25.1'</a:s>
                        </a:s>
                     </a:s>
                     <a:s> then </a:s>
                     <a:s r="958">
                        <a:s r="959">
                           <a:s>&quot;Clinical judgement is required. Create a clinical note&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="960">
                           <a:s r="961">
                              <a:s>&quot;Guidance&quot;</a:s>
                           </a:s>
                           <a:s> = </a:s>
                           <a:s r="962">
                              <a:s>'Members States should update this action according to the national immunization programme.'</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    else </a:s>
                  <a:s r="966">
                     <a:s>'No test case set'</a:s>
                  </a:s>
                  <a:s>
  end</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="641" locator="377:3-413:5" xsi:type="Case">
            <caseItem localId="642" locator="378:5-378:309">
               <when localId="643" locator="378:10-378:40" xsi:type="Equal">
                  <signature localId="650" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="651" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="648" name="ToString" libraryName="FHIRHelpers" xsi:type="FunctionRef">
                     <signature localId="649" name="fhir:string" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="645" locator="378:10-378:19" path="id" xsi:type="Property">
                        <source localId="644" locator="378:10-378:16" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="646" locator="378:23-378:40" valueType="t:String" value="Pneumococcal08.1" xsi:type="Literal"/>
               </when>
               <then localId="968" xsi:type="As">
                  <operand localId="652" locator="378:47-378:309" xsi:type="And">
                     <operand localId="653" locator="378:47-378:101" name="Client is not due for pneumococcal vaccination Case 1" xsi:type="ExpressionRef"/>
                     <operand localId="654" locator="378:107-378:309" xsi:type="Equal">
                        <signature localId="658" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <signature localId="659" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <operand localId="655" locator="378:107-378:116" name="Guidance" xsi:type="ExpressionRef"/>
                        <operand localId="656" locator="378:120-378:309" valueType="t:String" value="Should not vaccinate client with first pneumococcal dose as client's age is less than 6 weeks. Check for any vaccines due and inform the caregiver of when to come back for the first dose." xsi:type="Literal"/>
                     </operand>
                  </operand>
                  <asTypeSpecifier localId="969" xsi:type="ChoiceTypeSpecifier">
                     <choice localId="970" name="t:Boolean" xsi:type="NamedTypeSpecifier"/>
                     <choice localId="971" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  </asTypeSpecifier>
               </then>
            </caseItem>
            <caseItem localId="660" locator="379:5-379:289">
               <when localId="661" locator="379:10-379:40" xsi:type="Equal">
                  <signature localId="668" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="669" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="666" name="ToString" libraryName="FHIRHelpers" xsi:type="FunctionRef">
                     <signature localId="667" name="fhir:string" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="663" locator="379:10-379:19" path="id" xsi:type="Property">
                        <source localId="662" locator="379:10-379:16" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="664" locator="379:23-379:40" valueType="t:String" value="Pneumococcal09.2" xsi:type="Literal"/>
               </when>
               <then localId="972" xsi:type="As">
                  <operand localId="670" locator="379:47-379:289" xsi:type="And">
                     <operand localId="671" locator="379:47-379:97" name="Client is due for pneumococcal vaccination Case 1" xsi:type="ExpressionRef"/>
                     <operand localId="672" locator="379:103-379:289" xsi:type="Equal">
                        <signature localId="676" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <signature localId="677" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <operand localId="673" locator="379:103-379:112" name="Guidance" xsi:type="ExpressionRef"/>
                        <operand localId="674" locator="379:116-379:289" valueType="t:String" value="Should vaccinate client with first pneumococcal dose as no pneumococcal doses were administered and client is within the appropriate age range.&#xa;Check for contraindications." xsi:type="Literal"/>
                     </operand>
                  </operand>
                  <asTypeSpecifier localId="973" xsi:type="ChoiceTypeSpecifier">
                     <choice localId="974" name="t:Boolean" xsi:type="NamedTypeSpecifier"/>
                     <choice localId="975" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  </asTypeSpecifier>
               </then>
            </caseItem>
            <caseItem localId="678" locator="381:5-381:349">
               <when localId="679" locator="381:10-381:40" xsi:type="Equal">
                  <signature localId="686" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="687" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="684" name="ToString" libraryName="FHIRHelpers" xsi:type="FunctionRef">
                     <signature localId="685" name="fhir:string" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="681" locator="381:10-381:19" path="id" xsi:type="Property">
                        <source localId="680" locator="381:10-381:16" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="682" locator="381:23-381:40" valueType="t:String" value="Pneumococcal10.4" xsi:type="Literal"/>
               </when>
               <then localId="976" xsi:type="As">
                  <operand localId="688" locator="381:47-381:349" xsi:type="And">
                     <operand localId="689" locator="381:47-381:101" name="Client is not due for pneumococcal vaccination Case 2" xsi:type="ExpressionRef"/>
                     <operand localId="690" locator="381:107-381:349" xsi:type="Equal">
                        <signature localId="694" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <signature localId="695" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <operand localId="691" locator="381:107-381:116" name="Guidance" xsi:type="ExpressionRef"/>
                        <operand localId="692" locator="381:120-381:349" valueType="t:String" value="Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago. &#xa;Check for any other vaccines due and inform the caregiver of when to come back for the next dose." xsi:type="Literal"/>
                     </operand>
                  </operand>
                  <asTypeSpecifier localId="977" xsi:type="ChoiceTypeSpecifier">
                     <choice localId="978" name="t:Boolean" xsi:type="NamedTypeSpecifier"/>
                     <choice localId="979" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  </asTypeSpecifier>
               </then>
            </caseItem>
            <caseItem localId="696" locator="383:5-383:272">
               <when localId="697" locator="383:10-383:40" xsi:type="Equal">
                  <signature localId="704" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="705" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="702" name="ToString" libraryName="FHIRHelpers" xsi:type="FunctionRef">
                     <signature localId="703" name="fhir:string" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="699" locator="383:10-383:19" path="id" xsi:type="Property">
                        <source localId="698" locator="383:10-383:16" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="700" locator="383:23-383:40" valueType="t:String" value="Pneumococcal11.4" xsi:type="Literal"/>
               </when>
               <then localId="980" xsi:type="As">
                  <operand localId="706" locator="383:47-383:272" xsi:type="And">
                     <operand localId="707" locator="383:47-383:97" name="Client is due for pneumococcal vaccination Case 2" xsi:type="ExpressionRef"/>
                     <operand localId="708" locator="383:103-383:272" xsi:type="Equal">
                        <signature localId="712" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <signature localId="713" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <operand localId="709" locator="383:103-383:112" name="Guidance" xsi:type="ExpressionRef"/>
                        <operand localId="710" locator="383:116-383:272" valueType="t:String" value="Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago. &#xa;Check for contraindications." xsi:type="Literal"/>
                     </operand>
                  </operand>
                  <asTypeSpecifier localId="981" xsi:type="ChoiceTypeSpecifier">
                     <choice localId="982" name="t:Boolean" xsi:type="NamedTypeSpecifier"/>
                     <choice localId="983" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  </asTypeSpecifier>
               </then>
            </caseItem>
            <caseItem localId="714" locator="385:5-385:403">
               <when localId="715" locator="385:10-385:40" xsi:type="Equal">
                  <signature localId="722" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="723" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="720" name="ToString" libraryName="FHIRHelpers" xsi:type="FunctionRef">
                     <signature localId="721" name="fhir:string" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="717" locator="385:10-385:19" path="id" xsi:type="Property">
                        <source localId="716" locator="385:10-385:16" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="718" locator="385:23-385:40" valueType="t:String" value="Pneumococcal12.5" xsi:type="Literal"/>
               </when>
               <then localId="984" xsi:type="As">
                  <operand localId="724" locator="385:47-385:403" xsi:type="And">
                     <operand localId="725" locator="385:47-385:101" name="Client is not due for pneumococcal vaccination Case 3" xsi:type="ExpressionRef"/>
                     <operand localId="726" locator="385:107-385:403" xsi:type="Equal">
                        <signature localId="730" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <signature localId="731" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <operand localId="727" locator="385:107-385:116" name="Guidance" xsi:type="ExpressionRef"/>
                        <operand localId="728" locator="385:120-385:403" valueType="t:String" value="Should not vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered less than 8 weeks ago and client is at high risk for pneumococcal infection. &#xa;Check for any other vaccines due and inform the caregiver of when to come back for the next dose." xsi:type="Literal"/>
                     </operand>
                  </operand>
                  <asTypeSpecifier localId="985" xsi:type="ChoiceTypeSpecifier">
                     <choice localId="986" name="t:Boolean" xsi:type="NamedTypeSpecifier"/>
                     <choice localId="987" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  </asTypeSpecifier>
               </then>
            </caseItem>
            <caseItem localId="732" locator="387:5-387:326">
               <when localId="733" locator="387:10-387:40" xsi:type="Equal">
                  <signature localId="740" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="741" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="738" name="ToString" libraryName="FHIRHelpers" xsi:type="FunctionRef">
                     <signature localId="739" name="fhir:string" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="735" locator="387:10-387:19" path="id" xsi:type="Property">
                        <source localId="734" locator="387:10-387:16" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="736" locator="387:23-387:40" valueType="t:String" value="Pneumococcal13.5" xsi:type="Literal"/>
               </when>
               <then localId="988" xsi:type="As">
                  <operand localId="742" locator="387:47-387:326" xsi:type="And">
                     <operand localId="743" locator="387:47-387:97" name="Client is due for pneumococcal vaccination Case 3" xsi:type="ExpressionRef"/>
                     <operand localId="744" locator="387:103-387:326" xsi:type="Equal">
                        <signature localId="748" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <signature localId="749" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <operand localId="745" locator="387:103-387:112" name="Guidance" xsi:type="ExpressionRef"/>
                        <operand localId="746" locator="387:116-387:326" valueType="t:String" value="Should vaccinate client with second pneumococcal dose as the latest pneumococcal dose was administered more than 8 weeks ago and client is at high risk for pneumococcal infection. &#xa;Check for contraindications." xsi:type="Literal"/>
                     </operand>
                  </operand>
                  <asTypeSpecifier localId="989" xsi:type="ChoiceTypeSpecifier">
                     <choice localId="990" name="t:Boolean" xsi:type="NamedTypeSpecifier"/>
                     <choice localId="991" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  </asTypeSpecifier>
               </then>
            </caseItem>
            <caseItem localId="750" locator="389:5-389:245">
               <when localId="751" locator="389:10-389:40" xsi:type="Equal">
                  <signature localId="758" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="759" name="t:String" xsi:type="NamedTypeSpecifier"/>
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                     <operand localId="753" locator="389:10-389:19" path="id" xsi:type="Property">
                        <source localId="752" locator="389:10-389:16" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="754" locator="389:23-389:40" valueType="t:String" value="Pneumococcal14.4" xsi:type="Literal"/>
               </when>
               <then localId="992" xsi:type="As">
                  <operand localId="760" locator="389:47-389:245" xsi:type="And">
                     <operand localId="761" locator="389:47-389:101" name="Pneumococcal immunization schedule is complete Case 1" xsi:type="ExpressionRef"/>
                     <operand localId="762" locator="389:107-389:245" xsi:type="Equal">
                        <signature localId="766" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <signature localId="767" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <operand localId="763" locator="389:107-389:116" name="Guidance" xsi:type="ExpressionRef"/>
                        <operand localId="764" locator="389:120-389:245" valueType="t:String" value="Pneumococcal immunization schedule is complete. One primary series dose was administered. &#xa;Check for any other vaccines due." xsi:type="Literal"/>
                     </operand>
                  </operand>
                  <asTypeSpecifier localId="993" xsi:type="ChoiceTypeSpecifier">
                     <choice localId="994" name="t:Boolean" xsi:type="NamedTypeSpecifier"/>
                     <choice localId="995" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  </asTypeSpecifier>
               </then>
            </caseItem>
            <caseItem localId="768" locator="391:5-391:281">
               <when localId="769" locator="391:10-391:40" xsi:type="Equal">
                  <signature localId="776" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="777" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="774" name="ToString" libraryName="FHIRHelpers" xsi:type="FunctionRef">
                     <signature localId="775" name="fhir:string" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="771" locator="391:10-391:19" path="id" xsi:type="Property">
                        <source localId="770" locator="391:10-391:16" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="772" locator="391:23-391:40" valueType="t:String" value="Pneumococcal15.4" xsi:type="Literal"/>
               </when>
               <then localId="996" xsi:type="As">
                  <operand localId="778" locator="391:47-391:281" xsi:type="And">
                     <operand localId="779" locator="391:47-391:98" name="Client is due for pneumococcal booster dose Case 1" xsi:type="ExpressionRef"/>
                     <operand localId="780" locator="391:104-391:281" xsi:type="Equal">
                        <signature localId="784" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <signature localId="785" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <operand localId="781" locator="391:104-391:113" name="Guidance" xsi:type="ExpressionRef"/>
                        <operand localId="782" locator="391:117-391:281" valueType="t:String" value="Should vaccinate client with first pneumococcal booster dose as first pneumococcal dose was administered within 12 months post birth. &#xa;Check for contraindications." xsi:type="Literal"/>
                     </operand>
                  </operand>
                  <asTypeSpecifier localId="997" xsi:type="ChoiceTypeSpecifier">
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            <caseItem localId="786" locator="393:5-393:260">
               <when localId="787" locator="393:10-393:40" xsi:type="Equal">
                  <signature localId="794" name="t:String" xsi:type="NamedTypeSpecifier"/>
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                     <operand localId="789" locator="393:10-393:19" path="id" xsi:type="Property">
                        <source localId="788" locator="393:10-393:16" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="790" locator="393:23-393:40" valueType="t:String" value="Pneumococcal16.4" xsi:type="Literal"/>
               </when>
               <then localId="1000" xsi:type="As">
                  <operand localId="796" locator="393:47-393:260" xsi:type="And">
                     <operand localId="797" locator="393:47-393:101" name="Pneumococcal immunization schedule is complete Case 2" xsi:type="ExpressionRef"/>
                     <operand localId="798" locator="393:107-393:260" xsi:type="Equal">
                        <signature localId="802" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <signature localId="803" name="t:String" xsi:type="NamedTypeSpecifier"/>
                        <operand localId="799" locator="393:107-393:116" name="Guidance" xsi:type="ExpressionRef"/>
                        <operand localId="800" locator="393:120-393:260" valueType="t:String" value="Pneumococcal immunization schedule is complete. Two pneumococcal primary series doses were administered. &#xa;Check for any other vaccines due." xsi:type="Literal"/>
                     </operand>
                  </operand>
                  <asTypeSpecifier localId="1001" xsi:type="ChoiceTypeSpecifier">
                     <choice localId="1002" name="t:Boolean" xsi:type="NamedTypeSpecifier"/>
                     <choice localId="1003" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  </asTypeSpecifier>
               </then>
            </caseItem>
            <caseItem localId="804" locator="395:5-395:354">
               <when localId="805" locator="395:10-395:40" xsi:type="Equal">
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