<?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="405">
         <a:s>/*
  * Library: IMMZD2DTPneumococcalElements
  */
library IMMZD2DTPneumococcalElements</a:s>
      </a:s>
   </annotation>
   <identifier id="IMMZD2DTPneumococcalElements" 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="7:1-7:26" 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="8:1-8:35" 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="10:1-10:19" localIdentifier="WHOConcepts" path="http://smart.who.int/immunizations/WHOConcepts">
         <annotation xsi:type="a:Annotation">
            <a:s r="210">
               <a:s>include </a:s>
               <a:s>
                  <a:s>WHOConcepts</a:s>
               </a:s>
            </a:s>
         </annotation>
      </def>
      <def localId="212" locator="11:1-11:27" localIdentifier="WC" path="http://smart.who.int/immunizations/WHOCommon">
         <annotation xsi:type="a:Annotation">
            <a:s r="212">
               <a:s>include </a:s>
               <a:s>
                  <a:s>WHOCommon</a:s>
               </a:s>
               <a:s> called WC</a:s>
            </a:s>
         </annotation>
      </def>
      <def localId="214" locator="12:1-12:29" localIdentifier="WE" path="http://smart.who.int/immunizations/WHOElements">
         <annotation xsi:type="a:Annotation">
            <a:s r="214">
               <a:s>include </a:s>
               <a:s>
                  <a:s>WHOElements</a:s>
               </a:s>
               <a:s> called WE</a:s>
            </a:s>
         </annotation>
      </def>
      <def localId="216" locator="14:1-14:32" localIdentifier="Common" path="http://smart.who.int/immunizations/IMMZCommon">
         <annotation xsi:type="a:Annotation">
            <a:s r="216">
               <a:s>include </a:s>
               <a:s>
                  <a:s>IMMZCommon</a:s>
               </a:s>
               <a:s> called Common</a:s>
            </a:s>
         </annotation>
      </def>
      <def localId="218" locator="15:1-15:36" localIdentifier="Concepts" path="http://smart.who.int/immunizations/IMMZConcepts">
         <annotation xsi:type="a:Annotation">
            <a:s r="218">
               <a:s>include </a:s>
               <a:s>
                  <a:s>IMMZConcepts</a:s>
               </a:s>
               <a:s> called Concepts</a:s>
            </a:s>
         </annotation>
      </def>
      <def localId="220" locator="16:1-16:36" localIdentifier="Elements" path="http://smart.who.int/immunizations/IMMZElements">
         <annotation xsi:type="a:Annotation">
            <a:s r="220">
               <a:s>include </a:s>
               <a:s>
                  <a:s>IMMZElements</a:s>
               </a:s>
               <a:s> called Elements</a:s>
            </a:s>
         </annotation>
      </def>
   </includes>
   <contexts>
      <def localId="225" locator="19:1-19:15" name="Patient"/>
   </contexts>
   <statements>
      <def localId="223" locator="19:1-19:15" name="Patient" context="Patient">
         <expression localId="224" xsi:type="SingletonFrom">
            <operand localId="222" locator="19:1-19:15" dataType="fhir:Patient" templateId="http://hl7.org/fhir/StructureDefinition/Patient" xsi:type="Retrieve"/>
         </expression>
      </def>
      <def localId="228" locator="24:1-27:53" name="Pneumococcal Doses Administered to Patient" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Pneumococcal containing Doses Administered to Patient"/>
            <a:s r="228">
               <a:s>/*
@internal: Pneumococcal containing Doses Administered to Patient
*/
define &quot;Pneumococcal Doses Administered to Patient&quot;:
  </a:s>
               <a:s r="240">
                  <a:s>
                     <a:s r="229">
                        <a:s r="231">
                           <a:s>
                              <a:s>Elements.&quot;Doses Administered to Patient&quot;</a:s>
                           </a:s>
                        </a:s>
                        <a:s> I</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
  </a:s>
                  <a:s r="237">
                     <a:s>where
    </a:s>
                     <a:s r="237">
                        <a:s r="234">
                           <a:s r="233">
                              <a:s>I</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="234">
                              <a:s>vaccineCode</a:s>
                           </a:s>
                        </a:s>
                        <a:s> in </a:s>
                        <a:s r="236">
                           <a:s r="235">
                              <a:s>Concepts</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="236">
                              <a:s>&quot;Pneumococcal vaccines&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="240" locator="25:3-27:53" xsi:type="Query">
            <source localId="229" locator="25:3-25:44" alias="I">
               <expression localId="231" locator="25:3-25:42" name="Doses Administered to Patient" libraryName="Elements" xsi:type="ExpressionRef"/>
            </source>
            <where localId="237" locator="26:3-27:53" xsi:type="InValueSet">
               <signature localId="239" name="t:Concept" xsi:type="NamedTypeSpecifier"/>
               <code localId="238" name="ToConcept" libraryName="FHIRHelpers" xsi:type="FunctionRef">
                  <operand localId="234" locator="27:5-27:17" path="vaccineCode" scope="I" xsi:type="Property"/>
               </code>
               <valueset localId="236" locator="27:22-27:53" name="Pneumococcal vaccines" libraryName="Concepts" preserve="true"/>
            </where>
         </expression>
      </def>
      <def localId="243" locator="32:1-33:62" name="Pneumococcal Primary Series Doses Administered to Patient" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Pneumococcal containing Doses Administered to Patient that are in the Primary series"/>
            <a:s r="243">
               <a:s>/*
@internal: Pneumococcal containing Doses Administered to Patient that are in the Primary series
*/
define &quot;Pneumococcal Primary Series Doses Administered to Patient&quot;:
  </a:s>
               <a:s r="245">
                  <a:s r="244">
                     <a:s>&quot;Pneumococcal Doses Administered to Patient&quot;</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="245">
                     <a:s>seriesPrimary()</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="245" locator="33:3-33:62" name="seriesPrimary" libraryName="Common" xsi:type="FunctionRef">
            <operand localId="244" locator="33:3-33:46" name="Pneumococcal Doses Administered to Patient" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="248" locator="38:1-39:68" name="Number of Pneumococcal Primary Series Doses Administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Number of Pneumococcal Primary Series doses"/>
            <a:s r="248">
               <a:s>/*
@internal: Number of Pneumococcal Primary Series doses
*/
define &quot;Number of Pneumococcal Primary Series Doses Administered&quot;:
  </a:s>
               <a:s r="252">
                  <a:s>Count(</a:s>
                  <a:s r="249">
                     <a:s>&quot;Pneumococcal Primary Series Doses Administered to Patient&quot;</a:s>
                  </a:s>
                  <a:s>)</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="252" locator="39:3-39:68" xsi:type="Count">
            <source localId="249" locator="39:9-39:67" name="Pneumococcal Primary Series Doses Administered to Patient" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="255" locator="48:1-49:45" name="The client's age is less than 6 weeks" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The client's age is less than 6 weeks"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; &lt; 6 weeks"/>
            <a:t name="code" value="The client's age is less than 6 weeks-40"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="255">
               <a:s>/*
@input: The client's age is less than 6 weeks
@pseudocode: Today's date − &quot;Date of birth&quot; &lt; 6 weeks
@code: The client's age is less than 6 weeks-40
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The client's age is less than 6 weeks&quot;:
  </a:s>
               <a:s r="256">
                  <a:s r="258">
                     <a:s r="257">
                        <a:s>Elements</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="258">
                        <a:s>&quot;Current Patient Age In Weeks&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="259"> &lt; 6</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="256" locator="49:3-49:45" xsi:type="Less">
            <signature localId="260" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="261" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="258" locator="49:3-49:41" name="Current Patient Age In Weeks" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="259" locator="49:45" valueType="t:Integer" value="6" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="264" locator="58:1-59:64" name="No pneumococcal primary series doses were administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="No pneumococcal primary series doses were administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 0"/>
            <a:t name="code" value="No pneumococcal primary series doses were administered-121"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="264">
               <a:s>/*
@input: No pneumococcal primary series doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 0
@code: No pneumococcal primary series doses were administered-121
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;No pneumococcal primary series doses were administered&quot;:
  </a:s>
               <a:s r="265">
                  <a:s r="266">
                     <a:s>&quot;Number of Pneumococcal Primary Series Doses Administered&quot;</a:s>
                  </a:s>
                  <a:s r="267"> = 0</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="265" locator="59:3-59:64" xsi:type="Equal">
            <signature localId="268" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="269" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="266" locator="59:3-59:60" name="Number of Pneumococcal Primary Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="267" locator="59:64" valueType="t:Integer" value="0" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="272" locator="68:1-70:50" name="The client's age is between 6 weeks and 5 years" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The client's age is between 6 weeks and 5 years"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; ≤ 5 years"/>
            <a:t name="code" value="The client's age is between 6 weeks and 5 years-50"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="272">
               <a:s>/*
@input: The client's age is between 6 weeks and 5 years
@pseudocode: 6 weeks ≤ Today's date − &quot;Date of birth&quot; ≤ 5 years
@code: The client's age is between 6 weeks and 5 years-50
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The client's age is between 6 weeks and 5 years&quot;:
  </a:s>
               <a:s r="273">
                  <a:s r="274">
                     <a:s r="275">6 &lt;= </a:s>
                     <a:s r="277">
                        <a:s r="276">
                           <a:s>Elements</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="277">
                           <a:s>&quot;Current Patient Age In Weeks&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
  and </a:s>
                  <a:s r="280">
                     <a:s r="282">
                        <a:s r="281">
                           <a:s>Elements</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="282">
                           <a:s>&quot;Current Patient Age In Years&quot;</a:s>
                        </a:s>
                     </a:s>
                     <a:s r="283"> &lt;= 5</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="273" locator="69:3-70:50" xsi:type="And">
            <operand localId="274" locator="69:3-69:46" xsi:type="LessOrEqual">
               <signature localId="278" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="279" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="275" locator="69:3" valueType="t:Integer" value="6" xsi:type="Literal"/>
               <operand localId="277" locator="69:8-69:46" name="Current Patient Age In Weeks" libraryName="Elements" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="280" locator="70:7-70:50" xsi:type="LessOrEqual">
               <signature localId="284" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="285" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="282" locator="70:7-70:45" name="Current Patient Age In Years" libraryName="Elements" xsi:type="ExpressionRef"/>
               <operand localId="283" locator="70:50" valueType="t:Integer" value="5" xsi:type="Literal"/>
            </operand>
         </expression>
      </def>
      <def localId="288" locator="79:1-80:64" name="One pneumococcal primary series dose was administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="One pneumococcal primary series dose was administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 1"/>
            <a:t name="code" value="One pneumococcal primary series dose was administered-121"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="288">
               <a:s>/*
@input: One pneumococcal primary series dose was administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 1
@code: One pneumococcal primary series dose was administered-121
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;One pneumococcal primary series dose was administered&quot;:
  </a:s>
               <a:s r="289">
                  <a:s r="290">
                     <a:s>&quot;Number of Pneumococcal Primary Series Doses Administered&quot;</a:s>
                  </a:s>
                  <a:s r="291"> = 1</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="289" locator="80:3-80:64" xsi:type="Equal">
            <signature localId="292" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="293" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="290" locator="80:3-80:60" name="Number of Pneumococcal Primary Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="291" locator="80:64" valueType="t:Integer" value="1" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="296" locator="88:1-89:46" name="The client's age is less than or equal to 5 years" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The client's age is less than or equal to 5 years"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; ≤ 5 years"/>
            <a:t name="code" value="The client's age is less than or equal to 5 years-41"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:s r="296">
               <a:s>/*
@input: The client's age is less than or equal to 5 years
@pseudocode: 'Today's date − &quot;Date of birth&quot; ≤ 5 years
@code: The client's age is less than or equal to 5 years-41
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
*/
define &quot;The client's age is less than or equal to 5 years&quot;:
  </a:s>
               <a:s r="297">
                  <a:s r="299">
                     <a:s r="298">
                        <a:s>Elements</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="299">
                        <a:s>&quot;Current Patient Age In Years&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="300"> &lt;= 5</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="297" locator="89:3-89:46" xsi:type="LessOrEqual">
            <signature localId="301" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="302" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="299" locator="89:3-89:41" name="Current Patient Age In Years" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="300" locator="89:46" valueType="t:Integer" value="5" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="309" locator="368:1-369:100" name="Date of First Pneumococcal Dose" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Date of First Pneumococcal Dose"/>
            <a:s r="309">
               <a:s>/*
@internal: Date of First Pneumococcal Dose
*/
define &quot;Date of First Pneumococcal Dose&quot;:
  </a:s>
               <a:s r="310">
                  <a:s>date from </a:s>
                  <a:s r="311">
                     <a:s>start of </a:s>
                     <a:s r="317">
                        <a:s r="316">
                           <a:s r="313">
                              <a:s r="312">
                                 <a:s>&quot;Pneumococcal Doses Administered to Patient&quot;</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="313">
                                 <a:s>earliest()</a:s>
                              </a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="316">
                              <a:s>occurrence</a:s>
                           </a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="317">
                           <a:s>toInterval()</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="310" locator="369:3-369:100" xsi:type="DateFrom">
            <operand localId="311" locator="369:13-369:100" xsi:type="Start">
               <operand localId="317" locator="369:22-369:100" name="toInterval" libraryName="WC" xsi:type="FunctionRef">
                  <operand localId="316" locator="369:22-369:87" path="occurrence" xsi:type="Property">
                     <source localId="313" locator="369:22-369:76" name="earliest" libraryName="WC" xsi:type="FunctionRef">
                        <signature localId="314" xsi:type="ListTypeSpecifier">
                           <elementType localId="315" name="fhir:Immunization" xsi:type="NamedTypeSpecifier"/>
                        </signature>
                        <operand localId="312" locator="369:22-369:65" name="Pneumococcal Doses Administered to Patient" xsi:type="ExpressionRef"/>
                     </source>
                  </operand>
               </operand>
            </operand>
         </expression>
      </def>
      <def localId="305" locator="97:1-98:55" name="The first pneumococcal dose was administered within 24 months post birth" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The first pneumococcal dose was administered within 24 months post birth"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; &lt; 24 months"/>
            <a:t name="code" value="The first pneumococcal dose was administered within 24 months post birth-109"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:s r="305">
               <a:s>/*
@input: The first pneumococcal dose was administered within 24 months post birth
@pseudocode: &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; &lt; 24 months
@code: The first pneumococcal dose was administered within 24 months post birth-109
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
*/
define &quot;The first pneumococcal dose was administered within 24 months post birth&quot;:
  </a:s>
               <a:s r="306">
                  <a:s r="323">
                     <a:s>AgeInMonthsAt(</a:s>
                     <a:s r="318">
                        <a:s>&quot;Date of First Pneumococcal Dose&quot;</a:s>
                     </a:s>
                     <a:s>)</a:s>
                  </a:s>
                  <a:s r="326"> &lt; 24</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="306" locator="98:3-98:55" xsi:type="Less">
            <signature localId="327" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="328" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="323" locator="98:3-98:50" precision="Month" xsi:type="CalculateAgeAt">
               <signature localId="324" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <signature localId="325" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <operand localId="322" path="birthDate.value" xsi:type="Property">
                  <source localId="321" name="Patient" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="318" locator="98:17-98:49" name="Date of First Pneumococcal Dose" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="326" locator="98:54-98:55" valueType="t:Integer" value="24" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="335" locator="374:1-375:102" name="Date of Latest Pneumococcal Dose" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Date of Latest Pneumococcal Dose"/>
            <a:s r="335">
               <a:s>/*
@internal: Date of Latest Pneumococcal Dose
*/
define &quot;Date of Latest Pneumococcal Dose&quot;:
  </a:s>
               <a:s r="336">
                  <a:s>date from </a:s>
                  <a:s r="337">
                     <a:s>start of </a:s>
                     <a:s r="343">
                        <a:s r="342">
                           <a:s r="339">
                              <a:s r="338">
                                 <a:s>&quot;Pneumococcal Doses Administered to Patient&quot;</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="339">
                                 <a:s>mostRecent()</a:s>
                              </a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="342">
                              <a:s>occurrence</a:s>
                           </a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="343">
                           <a:s>toInterval()</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="336" locator="375:3-375:102" xsi:type="DateFrom">
            <operand localId="337" locator="375:13-375:102" xsi:type="Start">
               <operand localId="343" locator="375:22-375:102" name="toInterval" libraryName="WC" xsi:type="FunctionRef">
                  <operand localId="342" locator="375:22-375:89" path="occurrence" xsi:type="Property">
                     <source localId="339" locator="375:22-375:78" name="mostRecent" libraryName="WC" xsi:type="FunctionRef">
                        <signature localId="340" xsi:type="ListTypeSpecifier">
                           <elementType localId="341" name="fhir:Immunization" xsi:type="NamedTypeSpecifier"/>
                        </signature>
                        <operand localId="338" locator="375:22-375:65" name="Pneumococcal Doses Administered to Patient" xsi:type="ExpressionRef"/>
                     </source>
                  </operand>
               </operand>
            </operand>
         </expression>
      </def>
      <def localId="331" locator="107:1-109:82" name="The latest pneumococcal dose was administered less than 8 weeks ago" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest pneumococcal dose was administered less than 8 weeks ago"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) &lt; 8 weeks"/>
            <a:t name="code" value="The latest pneumococcal dose was administered less than 8 weeks ago-104"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="331">
               <a:s>/*
@input: The latest pneumococcal dose was administered less than 8 weeks ago
@pseudocode: Today's date − &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) &lt; 8 weeks
@code: The latest pneumococcal dose was administered less than 8 weeks ago-104
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The latest pneumococcal dose was administered less than 8 weeks ago&quot;:
  </a:s>
               <a:s r="332">
                  <a:s r="346">
                     <a:s r="344">
                        <a:s>&quot;Date of Latest Pneumococcal Dose&quot;</a:s>
                     </a:s>
                     <a:s> is not null</a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="347">
                     <a:s r="348">
                        <a:s>duration in weeks between </a:s>
                        <a:s r="349">
                           <a:s>&quot;Date of Latest Pneumococcal Dose&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="352">
                           <a:s>Now()</a:s>
                        </a:s>
                     </a:s>
                     <a:s r="358"> &lt; 8</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="332" locator="108:3-109:82" xsi:type="And">
            <operand localId="346" locator="108:3-108:48" xsi:type="Not">
               <operand localId="345" locator="108:3-108:48" xsi:type="IsNull">
                  <operand localId="344" locator="108:3-108:36" name="Date of Latest Pneumococcal Dose" xsi:type="ExpressionRef"/>
               </operand>
            </operand>
            <operand localId="347" locator="109:9-109:82" xsi:type="Less">
               <signature localId="359" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="360" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="348" locator="109:9-109:78" precision="Week" xsi:type="DurationBetween">
                  <signature localId="356" name="t:DateTime" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="357" name="t:DateTime" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="354" xsi:type="ToDateTime">
                     <signature localId="355" name="t:Date" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="349" locator="109:35-109:68" name="Date of Latest Pneumococcal Dose" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="352" locator="109:74-109:78" xsi:type="Now"/>
               </operand>
               <operand localId="358" locator="109:82" valueType="t:Integer" value="8" xsi:type="Literal"/>
            </operand>
         </expression>
      </def>
      <def localId="363" locator="118:1-119:75" name="The latest pneumococcal dose was administered more than 8 weeks ago" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest pneumococcal dose was administered more than 8 weeks ago"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) ≥ 8 weeks"/>
            <a:t name="code" value="The latest pneumococcal dose was administered more than 8 weeks ago-104"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="363">
               <a:s>/*
@input: The latest pneumococcal dose was administered more than 8 weeks ago
@pseudocode: Today's date − &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) ≥ 8 weeks
@code: The latest pneumococcal dose was administered more than 8 weeks ago-104
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The latest pneumococcal dose was administered more than 8 weeks ago&quot;:
  </a:s>
               <a:s r="364">
                  <a:s>not </a:s>
                  <a:s r="365">
                     <a:s>&quot;The latest pneumococcal dose was administered less than 8 weeks ago&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="364" locator="119:3-119:75" xsi:type="Not">
            <operand localId="365" locator="119:7-119:75" name="The latest pneumococcal dose was administered less than 8 weeks ago" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="368" locator="128:1-129:56" name="The first pneumococcal dose was administered after 24 months post birth" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The first pneumococcal dose was administered after 24 months post birth"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; ≥ 24 months"/>
            <a:t name="code" value="The first pneumococcal dose was administered after 24 months post birth-109"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="368">
               <a:s>/*
@input: The first pneumococcal dose was administered after 24 months post birth
@pseudocode: &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; ≥ 24 months
@code: The first pneumococcal dose was administered after 24 months post birth-109
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The first pneumococcal dose was administered after 24 months post birth&quot;:
  </a:s>
               <a:s r="369">
                  <a:s r="375">
                     <a:s>AgeInMonthsAt(</a:s>
                     <a:s r="370">
                        <a:s>&quot;Date of First Pneumococcal Dose&quot;</a:s>
                     </a:s>
                     <a:s>)</a:s>
                  </a:s>
                  <a:s r="378"> >= 24</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="369" locator="129:3-129:56" xsi:type="GreaterOrEqual">
            <signature localId="379" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="380" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="375" locator="129:3-129:50" precision="Month" xsi:type="CalculateAgeAt">
               <signature localId="376" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <signature localId="377" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <operand localId="374" path="birthDate.value" xsi:type="Property">
                  <source localId="373" name="Patient" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="370" locator="129:17-129:49" name="Date of First Pneumococcal Dose" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="378" locator="129:55-129:56" valueType="t:Integer" value="24" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="383" locator="138:1-139:62" name="Client is at high risk for pneumococcal infection" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client is at high risk for pneumococcal infection"/>
            <a:t name="pseudocode" value="&quot;At high risk for pneumococcal infection&quot; = TRUE"/>
            <a:t name="code" value="Client is at high risk for pneumococcal infection-48"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="383">
               <a:s>/*
@input: Client is at high risk for pneumococcal infection
@pseudocode: &quot;At high risk for pneumococcal infection&quot; = TRUE
@code: Client is at high risk for pneumococcal infection-48
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;Client is at high risk for pneumococcal infection&quot;:
  </a:s>
               <a:s r="385">
                  <a:s r="384">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="385">
                     <a:s>&quot;Client is at high risk for pneumococcal infection&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="385" locator="139:3-139:62" name="Client is at high risk for pneumococcal infection" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
      <def localId="388" locator="148:1-149:66" name="Client is not at high risk for pneumococcal infection" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client is not at high risk for pneumococcal infection"/>
            <a:t name="pseudocode" value="&quot;At high risk for pneumococcal infection&quot; = FALSE"/>
            <a:t name="code" value="Client is not at high risk for pneumococcal infection-49"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="388">
               <a:s>/*
@input: Client is not at high risk for pneumococcal infection
@pseudocode: &quot;At high risk for pneumococcal infection&quot; = FALSE
@code: Client is not at high risk for pneumococcal infection-49
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;Client is not at high risk for pneumococcal infection&quot;:
  </a:s>
               <a:s r="390">
                  <a:s r="389">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="390">
                     <a:s>&quot;Client is not at high risk for pneumococcal infection&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="390" locator="149:3-149:66" name="Client is not at high risk for pneumococcal infection" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
      <def localId="393" locator="158:1-159:64" name="Two pneumococcal primary series doses were administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Two pneumococcal primary series doses were administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 2"/>
            <a:t name="code" value="Two pneumococcal primary series doses were administered-121"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="393">
               <a:s>/*
@input: Two pneumococcal primary series doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 2
@code: Two pneumococcal primary series doses were administered-121
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;Two pneumococcal primary series doses were administered&quot;:
  </a:s>
               <a:s r="394">
                  <a:s r="395">
                     <a:s>&quot;Number of Pneumococcal Primary Series Doses Administered&quot;</a:s>
                  </a:s>
                  <a:s r="396"> = 2</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="394" locator="159:3-159:64" xsi:type="Equal">
            <signature localId="397" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="398" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="395" locator="159:3-159:60" name="Number of Pneumococcal Primary Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="396" locator="159:64" valueType="t:Integer" value="2" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="408" locator="380:1-381:62" name="Pneumococcal Booster Series Doses Administered to Patient" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Pneumococcal Booster Series Doses Administered to Patient"/>
            <a:s r="408">
               <a:s>/*
@internal: Pneumococcal Booster Series Doses Administered to Patient
*/
define &quot;Pneumococcal Booster Series Doses Administered to Patient&quot;:
  </a:s>
               <a:s r="410">
                  <a:s r="409">
                     <a:s>&quot;Pneumococcal Doses Administered to Patient&quot;</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="410">
                     <a:s>seriesBooster()</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="410" locator="381:3-381:62" name="seriesBooster" libraryName="Common" xsi:type="FunctionRef">
            <operand localId="409" locator="381:3-381:46" name="Pneumococcal Doses Administered to Patient" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="405" locator="386:1-387:68" name="Number of Pneumococcal Booster Series Doses Administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Number of Pneumococcal Booster Series Doses Administered"/>
            <a:s r="405">
               <a:s>/*
@internal: Number of Pneumococcal Booster Series Doses Administered
*/
define &quot;Number of Pneumococcal Booster Series Doses Administered&quot;:
  </a:s>
               <a:s r="414">
                  <a:s>Count(</a:s>
                  <a:s r="411">
                     <a:s>&quot;Pneumococcal Booster Series Doses Administered to Patient&quot;</a:s>
                  </a:s>
                  <a:s>)</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="414" locator="387:3-387:68" xsi:type="Count">
            <source localId="411" locator="387:9-387:67" name="Pneumococcal Booster Series Doses Administered to Patient" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="401" locator="168:1-169:64" name="No pneumococcal booster dose was administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="No pneumococcal booster dose was administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Booster dose&quot;) = 0"/>
            <a:t name="code" value="No pneumococcal booster dose was administered-119"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="401">
               <a:s>/*
@input: No pneumococcal booster dose was administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Booster dose&quot;) = 0
@code: No pneumococcal booster dose was administered-119
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;No pneumococcal booster dose was administered&quot;:
  </a:s>
               <a:s r="402">
                  <a:s r="415">
                     <a:s>&quot;Number of Pneumococcal Booster Series Doses Administered&quot;</a:s>
                  </a:s>
                  <a:s r="416"> = 0</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="402" locator="169:3-169:64" xsi:type="Equal">
            <signature localId="417" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="418" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="415" locator="169:3-169:60" name="Number of Pneumococcal Booster Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="416" locator="169:64" valueType="t:Integer" value="0" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="421" locator="178:1-179:55" name="The first pneumococcal dose was administered within 12 months post birth" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The first pneumococcal dose was administered within 12 months post birth"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; AND &quot;Dose number&quot; = 1) − &quot;Date of birth&quot; &lt; 12 months"/>
            <a:t name="code" value="The first pneumococcal dose was administered within 12 months post birth-131"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="421">
               <a:s>/*
@input: The first pneumococcal dose was administered within 12 months post birth
@pseudocode: &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; AND &quot;Dose number&quot; = 1) − &quot;Date of birth&quot; &lt; 12 months
@code: The first pneumococcal dose was administered within 12 months post birth-131
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The first pneumococcal dose was administered within 12 months post birth&quot;:
  </a:s>
               <a:s r="422">
                  <a:s r="428">
                     <a:s>AgeInMonthsAt(</a:s>
                     <a:s r="423">
                        <a:s>&quot;Date of First Pneumococcal Dose&quot;</a:s>
                     </a:s>
                     <a:s>)</a:s>
                  </a:s>
                  <a:s r="431"> &lt; 12</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="422" locator="179:3-179:55" xsi:type="Less">
            <signature localId="432" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="433" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="428" locator="179:3-179:50" precision="Month" xsi:type="CalculateAgeAt">
               <signature localId="429" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <signature localId="430" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <operand localId="427" path="birthDate.value" xsi:type="Property">
                  <source localId="426" name="Patient" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="423" locator="179:17-179:49" name="Date of First Pneumococcal Dose" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="431" locator="179:54-179:55" valueType="t:Integer" value="12" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="436" locator="188:1-189:56" name="The first pneumococcal dose was administered after 12 months post birth" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The first pneumococcal dose was administered after 12 months post birth"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; AND &quot;Dose number&quot; = 1) − &quot;Date of birth&quot; ≥ 12 months"/>
            <a:t name="code" value="The first pneumococcal dose was administered after 12 months post birth-131"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="436">
               <a:s>/*
@input: The first pneumococcal dose was administered after 12 months post birth
@pseudocode: &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; AND &quot;Dose number&quot; = 1) − &quot;Date of birth&quot; ≥ 12 months
@code: The first pneumococcal dose was administered after 12 months post birth-131
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The first pneumococcal dose was administered after 12 months post birth&quot;:
  </a:s>
               <a:s r="437">
                  <a:s r="443">
                     <a:s>AgeInMonthsAt(</a:s>
                     <a:s r="438">
                        <a:s>&quot;Date of First Pneumococcal Dose&quot;</a:s>
                     </a:s>
                     <a:s>)</a:s>
                  </a:s>
                  <a:s r="446"> >= 12</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="437" locator="189:3-189:56" xsi:type="GreaterOrEqual">
            <signature localId="447" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="448" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="443" locator="189:3-189:50" precision="Month" xsi:type="CalculateAgeAt">
               <signature localId="444" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <signature localId="445" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <operand localId="442" path="birthDate.value" xsi:type="Property">
                  <source localId="441" name="Patient" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="438" locator="189:17-189:49" name="Date of First Pneumococcal Dose" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="446" locator="189:55-189:56" valueType="t:Integer" value="12" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="451" locator="198:1-199:64" name="One pneumococcal booster dose was administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="One pneumococcal booster dose was administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Booster dose&quot;) = 1"/>
            <a:t name="code" value="One pneumococcal booster dose was administered-119"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="451">
               <a:s>/*
@input: One pneumococcal booster dose was administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Booster dose&quot;) = 1
@code: One pneumococcal booster dose was administered-119
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;One pneumococcal booster dose was administered&quot;:
  </a:s>
               <a:s r="452">
                  <a:s r="453">
                     <a:s>&quot;Number of Pneumococcal Booster Series Doses Administered&quot;</a:s>
                  </a:s>
                  <a:s r="454"> = 1</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="452" locator="199:3-199:64" xsi:type="Equal">
            <signature localId="455" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="456" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="453" locator="199:3-199:60" name="Number of Pneumococcal Booster Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="454" locator="199:64" valueType="t:Integer" value="1" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="459" locator="207:1-208:47" name="The client's age is less than 12 months" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The client's age is less than 12 months"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; &lt; 12 months"/>
            <a:t name="code" value="The client's age is less than 12 months-42"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:s r="459">
               <a:s>/*
@input: The client's age is less than 12 months
@pseudocode: Today's date − &quot;Date of birth&quot; &lt; 12 months
@code: The client's age is less than 12 months-42
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
*/
define &quot;The client's age is less than 12 months&quot;:
  </a:s>
               <a:s r="460">
                  <a:s r="462">
                     <a:s r="461">
                        <a:s>Elements</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="462">
                        <a:s>&quot;Current Patient Age In Months&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="463"> &lt; 12</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="460" locator="208:3-208:47" xsi:type="Less">
            <signature localId="464" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="465" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="462" locator="208:3-208:42" name="Current Patient Age In Months" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="463" locator="208:46-208:47" valueType="t:Integer" value="12" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="468" locator="217:1-218:44" name="Client's HIV status is positive" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client's HIV status is positive"/>
            <a:t name="pseudocode" value="&quot;HIV status&quot; = &quot;HIV-positive&quot;"/>
            <a:t name="code" value="Client's HIV status is positive-29"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="468">
               <a:s>/*
@input: Client's HIV status is positive
@pseudocode: &quot;HIV status&quot; = &quot;HIV-positive&quot;
@code: Client's HIV status is positive-29
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;Client's HIV status is positive&quot;:
  </a:s>
               <a:s r="470">
                  <a:s r="469">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="470">
                     <a:s>&quot;Client's HIV status is positive&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="470" locator="218:3-218:44" name="Client's HIV status is positive" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
      <def localId="473" locator="227:1-228:51" name="Client had preterm birth" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client had preterm birth"/>
            <a:t name="pseudocode" value="&quot;Preterm birth&quot; = TRUE"/>
            <a:t name="code" value="Client had preterm birth-22"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="473">
               <a:s>/*
@input: Client had preterm birth
@pseudocode: &quot;Preterm birth&quot; = TRUE
@code: Client had preterm birth-22
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;Client had preterm birth&quot;:
  </a:s>
               <a:s r="475">
                  <a:s r="474">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="475">
                     <a:s>&quot;Client was a premature infant at birth&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="475" locator="228:3-228:51" name="Client was a premature infant at birth" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
      <def localId="478" locator="236:1-238:51" name="The client's age is more than or equal to 12 months and less than 24 months" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The client's age is more than or equal to 12 months and less than 24 months"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; &lt; 24 months"/>
            <a:t name="code" value="The client's age is more than or equal to 12 months and less than 24 months-54"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:s r="478">
               <a:s>/*
@input: The client's age is more than or equal to 12 months and less than 24 months
@pseudocode: 12 months ≤ Today's date − &quot;Date of birth&quot; &lt; 24 months
@code: The client's age is more than or equal to 12 months and less than 24 months-54
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
*/
define &quot;The client's age is more than or equal to 12 months and less than 24 months&quot;:
  </a:s>
               <a:s r="479">
                  <a:s r="480">
                     <a:s r="481">12 &lt;= </a:s>
                     <a:s r="483">
                        <a:s r="482">
                           <a:s>Elements</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="483">
                           <a:s>&quot;Current Patient Age In Months&quot;</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
                  <a:s>
  and </a:s>
                  <a:s r="486">
                     <a:s r="488">
                        <a:s r="487">
                           <a:s>Elements</a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="488">
                           <a:s>&quot;Current Patient Age In Months&quot;</a:s>
                        </a:s>
                     </a:s>
                     <a:s r="489"> &lt; 24</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="479" locator="237:3-238:51" xsi:type="And">
            <operand localId="480" locator="237:3-237:48" xsi:type="LessOrEqual">
               <signature localId="484" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="485" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="481" locator="237:3-237:4" valueType="t:Integer" value="12" xsi:type="Literal"/>
               <operand localId="483" locator="237:9-237:48" name="Current Patient Age In Months" libraryName="Elements" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="486" locator="238:7-238:51" xsi:type="Less">
               <signature localId="490" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="491" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="488" locator="238:7-238:46" name="Current Patient Age In Months" libraryName="Elements" xsi:type="ExpressionRef"/>
               <operand localId="489" locator="238:50-238:51" valueType="t:Integer" value="24" xsi:type="Literal"/>
            </operand>
         </expression>
      </def>
      <def localId="494" locator="247:1-248:56" name="The latest pneumococcal dose was administered within 12 months post birth" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest pneumococcal dose was administered within 12 months post birth"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; &lt; 12 months"/>
            <a:t name="code" value="The latest pneumococcal dose was administered within 12 months post birth-116"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="494">
               <a:s>/*
@input: The latest pneumococcal dose was administered within 12 months post birth
@pseudocode: Latest &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; &lt; 12 months
@code: The latest pneumococcal dose was administered within 12 months post birth-116
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The latest pneumococcal dose was administered within 12 months post birth&quot;:
  </a:s>
               <a:s r="495">
                  <a:s r="501">
                     <a:s>AgeInMonthsAt(</a:s>
                     <a:s r="496">
                        <a:s>&quot;Date of Latest Pneumococcal Dose&quot;</a:s>
                     </a:s>
                     <a:s>)</a:s>
                  </a:s>
                  <a:s r="504"> &lt; 12</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="495" locator="248:3-248:56" xsi:type="Less">
            <signature localId="505" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="506" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="501" locator="248:3-248:51" precision="Month" xsi:type="CalculateAgeAt">
               <signature localId="502" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <signature localId="503" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <operand localId="500" path="birthDate.value" xsi:type="Property">
                  <source localId="499" name="Patient" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="496" locator="248:17-248:50" name="Date of Latest Pneumococcal Dose" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="504" locator="248:55-248:56" valueType="t:Integer" value="12" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="509" locator="257:1-258:57" name="The latest pneumococcal dose was administered after 12 months post birth" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest pneumococcal dose was administered after 12 months post birth"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; ≥ 12 months"/>
            <a:t name="code" value="The latest pneumococcal dose was administered after 12 months post birth-116"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="509">
               <a:s>/*
@input: The latest pneumococcal dose was administered after 12 months post birth
@pseudocode: Latest &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; ≥ 12 months
@code: The latest pneumococcal dose was administered after 12 months post birth-116
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The latest pneumococcal dose was administered after 12 months post birth&quot;:
  </a:s>
               <a:s r="510">
                  <a:s r="516">
                     <a:s>AgeInMonthsAt(</a:s>
                     <a:s r="511">
                        <a:s>&quot;Date of Latest Pneumococcal Dose&quot;</a:s>
                     </a:s>
                     <a:s>)</a:s>
                  </a:s>
                  <a:s r="519"> >= 12</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="510" locator="258:3-258:57" xsi:type="GreaterOrEqual">
            <signature localId="520" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="521" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="516" locator="258:3-258:51" precision="Month" xsi:type="CalculateAgeAt">
               <signature localId="517" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <signature localId="518" name="t:Date" xsi:type="NamedTypeSpecifier"/>
               <operand localId="515" path="birthDate.value" xsi:type="Property">
                  <source localId="514" name="Patient" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="511" locator="258:17-258:50" name="Date of Latest Pneumococcal Dose" xsi:type="ExpressionRef"/>
            </operand>
            <operand localId="519" locator="258:56-258:57" valueType="t:Integer" value="12" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="524" locator="267:1-268:55" name="Client's HIV status is negative or unknown" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client's HIV status is negative or unknown"/>
            <a:t name="pseudocode" value="&quot;HIV status&quot; ≠ &quot;HIV-positive&quot;"/>
            <a:t name="code" value="Client's HIV status is negative or unknown-29"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="524">
               <a:s>/*
@input: Client's HIV status is negative or unknown
@pseudocode: &quot;HIV status&quot; ≠ &quot;HIV-positive&quot;
@code: Client's HIV status is negative or unknown-29
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;Client's HIV status is negative or unknown&quot;:
  </a:s>
               <a:s r="526">
                  <a:s r="525">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="526">
                     <a:s>&quot;Client's HIV status is negative or unknown&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="526" locator="268:3-268:55" name="Client's HIV status is negative or unknown" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
      <def localId="529" locator="277:1-278:55" name="Client did not have preterm birth" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client did not have preterm birth"/>
            <a:t name="pseudocode" value="&quot;Preterm birth&quot; ≠ TRUE"/>
            <a:t name="code" value="Client did not have preterm birth-22"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="529">
               <a:s>/*
@input: Client did not have preterm birth
@pseudocode: &quot;Preterm birth&quot; ≠ TRUE
@code: Client did not have preterm birth-22
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;Client did not have preterm birth&quot;:
  </a:s>
               <a:s r="531">
                  <a:s r="530">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="531">
                     <a:s>&quot;Client was not a premature infant at birth&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="531" locator="278:3-278:55" name="Client was not a premature infant at birth" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
      <def localId="534" locator="287:1-288:48" name="The client's age is more than or equal to 24 months" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The client's age is more than or equal to 24 months"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; ≥ 24 months"/>
            <a:t name="code" value="The client's age is more than or equal to 24 months-42"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="534">
               <a:s>/*
@input: The client's age is more than or equal to 24 months
@pseudocode: Today's date − &quot;Date of birth&quot; ≥ 24 months
@code: The client's age is more than or equal to 24 months-42
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The client's age is more than or equal to 24 months&quot;:
  </a:s>
               <a:s r="535">
                  <a:s r="537">
                     <a:s r="536">
                        <a:s>Elements</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="537">
                        <a:s>&quot;Current Patient Age In Months&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="538"> >= 24</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="535" locator="288:3-288:48" xsi:type="GreaterOrEqual">
            <signature localId="539" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="540" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="537" locator="288:3-288:42" name="Current Patient Age In Months" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="538" locator="288:47-288:48" valueType="t:Integer" value="24" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="543" locator="296:1-297:64" name="Two pneumococcal booster doses were administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Two pneumococcal booster doses were administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Booster dose&quot;) = 2"/>
            <a:t name="code" value="Two pneumococcal booster doses were administered-119"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:s r="543">
               <a:s>/*
@input: Two pneumococcal booster doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Booster dose&quot;) = 2
@code: Two pneumococcal booster doses were administered-119
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
*/
define &quot;Two pneumococcal booster doses were administered&quot;:
  </a:s>
               <a:s r="544">
                  <a:s r="545">
                     <a:s>&quot;Number of Pneumococcal Booster Series Doses Administered&quot;</a:s>
                  </a:s>
                  <a:s r="546"> = 2</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="544" locator="297:3-297:64" xsi:type="Equal">
            <signature localId="547" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="548" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="545" locator="297:3-297:60" name="Number of Pneumococcal Booster Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="546" locator="297:64" valueType="t:Integer" value="2" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="551" locator="306:1-307:46" name="The client's age is more than 5 years" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The client's age is more than 5 years"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; > 5 years"/>
            <a:t name="code" value="The client's age is more than 5 years-40"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="551">
               <a:s>/*
@input: The client's age is more than 5 years
@pseudocode: Today's date − &quot;Date of birth&quot; > 5 years
@code: The client's age is more than 5 years-40
@decision: IMMZ.D2.DT.Pneumococcal.2 doses with booster dose: 2 primary doses with a booster dose (2p+1)
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The client's age is more than 5 years&quot;:
  </a:s>
               <a:s r="552">
                  <a:s r="554">
                     <a:s r="553">
                        <a:s>Elements</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="554">
                        <a:s>&quot;Current Patient Age In Months&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="555"> > 5</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="552" locator="307:3-307:46" xsi:type="Greater">
            <signature localId="556" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="557" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="554" locator="307:3-307:42" name="Current Patient Age In Months" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="555" locator="307:46" valueType="t:Integer" value="5" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="560" locator="315:1-316:53" name="The client's age is less than or equal to five years" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The client's age is less than or equal to five years"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; ≤ 5 years"/>
            <a:t name="code" value="The client's age is less than or equal to five years-40"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="560">
               <a:s>/*
@input: The client's age is less than or equal to five years
@pseudocode: Today's date − &quot;Date of birth&quot; ≤ 5 years
@code: The client's age is less than or equal to five years-40
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The client's age is less than or equal to five years&quot;:
  </a:s>
               <a:s r="561">
                  <a:s>&quot;The client's age is less than or equal to 5 years&quot;</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="561" locator="316:3-316:53" name="The client's age is less than or equal to 5 years" xsi:type="ExpressionRef"/>
      </def>
      <def localId="564" locator="324:1-326:82" name="The latest pneumococcal dose was administered less than 4 weeks ago" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest pneumococcal dose was administered less than 4 weeks ago"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) &lt; 4 weeks"/>
            <a:t name="code" value="The latest pneumococcal dose was administered less than 4 weeks ago-104"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="564">
               <a:s>/*
@input: The latest pneumococcal dose was administered less than 4 weeks ago
@pseudocode: Today's date − &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) &lt; 4 weeks
@code: The latest pneumococcal dose was administered less than 4 weeks ago-104
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The latest pneumococcal dose was administered less than 4 weeks ago&quot;:
  </a:s>
               <a:s r="565">
                  <a:s r="568">
                     <a:s r="566">
                        <a:s>&quot;Date of Latest Pneumococcal Dose&quot;</a:s>
                     </a:s>
                     <a:s> is not null</a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="569">
                     <a:s r="570">
                        <a:s>duration in weeks between </a:s>
                        <a:s r="571">
                           <a:s>&quot;Date of Latest Pneumococcal Dose&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="574">
                           <a:s>Now()</a:s>
                        </a:s>
                     </a:s>
                     <a:s r="580"> &lt; 4</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="565" locator="325:3-326:82" xsi:type="And">
            <operand localId="568" locator="325:3-325:48" xsi:type="Not">
               <operand localId="567" locator="325:3-325:48" xsi:type="IsNull">
                  <operand localId="566" locator="325:3-325:36" name="Date of Latest Pneumococcal Dose" xsi:type="ExpressionRef"/>
               </operand>
            </operand>
            <operand localId="569" locator="326:9-326:82" xsi:type="Less">
               <signature localId="581" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="582" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="570" locator="326:9-326:78" precision="Week" xsi:type="DurationBetween">
                  <signature localId="578" name="t:DateTime" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="579" name="t:DateTime" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="576" xsi:type="ToDateTime">
                     <signature localId="577" name="t:Date" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="571" locator="326:35-326:68" name="Date of Latest Pneumococcal Dose" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="574" locator="326:74-326:78" xsi:type="Now"/>
               </operand>
               <operand localId="580" locator="326:82" valueType="t:Integer" value="4" xsi:type="Literal"/>
            </operand>
         </expression>
      </def>
      <def localId="585" locator="334:1-335:75" name="The latest pneumococcal dose was administered more than 4 weeks ago" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest pneumococcal dose was administered more than 4 weeks ago"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) ≥ 4 weeks"/>
            <a:t name="code" value="The latest pneumococcal dose was administered more than 4 weeks ago-104"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="585">
               <a:s>/*
@input: The latest pneumococcal dose was administered more than 4 weeks ago
@pseudocode: Today's date − &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) ≥ 4 weeks
@code: The latest pneumococcal dose was administered more than 4 weeks ago-104
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The latest pneumococcal dose was administered more than 4 weeks ago&quot;:
  </a:s>
               <a:s r="586">
                  <a:s>not </a:s>
                  <a:s r="587">
                     <a:s>&quot;The latest pneumococcal dose was administered less than 4 weeks ago&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="586" locator="335:3-335:75" xsi:type="Not">
            <operand localId="587" locator="335:7-335:75" name="The latest pneumococcal dose was administered less than 4 weeks ago" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="590" locator="343:1-345:59" name="The first pneumococcal dose was administered at 12–24 months post birth" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The first pneumococcal dose was administered at 12–24 months post birth"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; &lt; 24 months"/>
            <a:t name="code" value="The first pneumococcal dose was administered at 12–24 months post birth-121"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="590">
               <a:s>/*
@input: The first pneumococcal dose was administered at 12–24 months post birth
@pseudocode: 12 months ≤ &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot;) − &quot;Date of birth&quot; &lt; 24 months
@code: The first pneumococcal dose was administered at 12–24 months post birth-121
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The first pneumococcal dose was administered at 12–24 months post birth&quot;:
  </a:s>
               <a:s r="591">
                  <a:s r="592">
                     <a:s r="598">
                        <a:s>AgeInMonthsAt(</a:s>
                        <a:s r="593">
                           <a:s>&quot;Date of First Pneumococcal Dose&quot;</a:s>
                        </a:s>
                        <a:s>)</a:s>
                     </a:s>
                     <a:s r="601"> >= 12</a:s>
                  </a:s>
                  <a:s>
  and </a:s>
                  <a:s r="604">
                     <a:s r="610">
                        <a:s>AgeInMonthsAt(</a:s>
                        <a:s r="605">
                           <a:s>&quot;Date of First Pneumococcal Dose&quot;</a:s>
                        </a:s>
                        <a:s>)</a:s>
                     </a:s>
                     <a:s r="613"> &lt; 24</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="591" locator="344:3-345:59" xsi:type="And">
            <operand localId="592" locator="344:3-344:56" xsi:type="GreaterOrEqual">
               <signature localId="602" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="603" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="598" locator="344:3-344:50" precision="Month" xsi:type="CalculateAgeAt">
                  <signature localId="599" name="t:Date" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="600" name="t:Date" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="597" path="birthDate.value" xsi:type="Property">
                     <source localId="596" name="Patient" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="593" locator="344:17-344:49" name="Date of First Pneumococcal Dose" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="601" locator="344:55-344:56" valueType="t:Integer" value="12" xsi:type="Literal"/>
            </operand>
            <operand localId="604" locator="345:7-345:59" xsi:type="Less">
               <signature localId="614" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="615" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="610" locator="345:7-345:54" precision="Month" xsi:type="CalculateAgeAt">
                  <signature localId="611" name="t:Date" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="612" name="t:Date" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="609" path="birthDate.value" xsi:type="Property">
                     <source localId="608" name="Patient" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="605" locator="345:21-345:53" name="Date of First Pneumococcal Dose" xsi:type="ExpressionRef"/>
               </operand>
               <operand localId="613" locator="345:58-345:59" valueType="t:Integer" value="24" xsi:type="Literal"/>
            </operand>
         </expression>
      </def>
      <def localId="618" locator="353:1-354:64" name="Three pneumococcal primary series doses were administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Three pneumococcal primary series doses were administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 3"/>
            <a:t name="code" value="Three pneumococcal primary series doses were administered-121"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="618">
               <a:s>/*
@input: Three pneumococcal primary series doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Pneumococcal vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 3
@code: Three pneumococcal primary series doses were administered-121
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;Three pneumococcal primary series doses were administered&quot;:
  </a:s>
               <a:s r="619">
                  <a:s r="620">
                     <a:s>&quot;Number of Pneumococcal Primary Series Doses Administered&quot;</a:s>
                  </a:s>
                  <a:s r="621"> = 3</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="619" locator="354:3-354:64" xsi:type="Equal">
            <signature localId="622" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="623" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="620" locator="354:3-354:60" name="Number of Pneumococcal Primary Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="621" locator="354:64" valueType="t:Integer" value="3" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="626" locator="362:1-363:47" name="The client's age is less than 24 months" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The client's age is less than 24 months"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; &lt; 24 months"/>
            <a:t name="code" value="The client's age is less than 24 months-42"/>
            <a:t name="decision" value="IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)"/>
            <a:s r="626">
               <a:s>/*
@input: The client's age is less than 24 months
@pseudocode: Today's date − &quot;Date of birth&quot; &lt; 24 months
@code: The client's age is less than 24 months-42
@decision: IMMZ.D2.DT.Pneumococcal.3 doses: 3 primary doses (3p+0)
*/
define &quot;The client's age is less than 24 months&quot;:
  </a:s>
               <a:s r="627">
                  <a:s r="629">
                     <a:s r="628">
                        <a:s>Elements</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="629">
                        <a:s>&quot;Current Patient Age In Months&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="630"> &lt; 24</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="627" locator="363:3-363:47" xsi:type="Less">
            <signature localId="631" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="632" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="629" locator="363:3-363:42" name="Current Patient Age In Months" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="630" locator="363:46-363:47" valueType="t:Integer" value="24" xsi:type="Literal"/>
         </expression>
      </def>
   </statements>
</library>
