<?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="302">
         <a:s>/*
  * Library: IMMZD2DTSeasonalinfluenzaElements
  */
library IMMZD2DTSeasonalinfluenzaElements</a:s>
      </a:s>
   </annotation>
   <identifier id="IMMZD2DTSeasonalinfluenzaElements" 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="24:1-27:59" name="Seasonal influenza Doses Administered to Patient" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Seasonal influenza containing Doses Administered to Patient"/>
            <a:s r="228">
               <a:s>/*
@internal: Seasonal influenza containing Doses Administered to Patient
*/
define &quot;Seasonal influenza 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;Seasonal influenza vaccines&quot;</a:s>
                           </a:s>
                        </a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="240" locator="25:3-27:59" 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="26:3-27:59" 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="27:22-27:59" name="Seasonal influenza vaccines" libraryName="Concepts" preserve="true"/>
            </where>
         </expression>
      </def>
      <def localId="243" locator="32:1-33:68" name="Seasonal influenza Primary Series Doses Administered to Patient" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Seasonal influenza containing Doses Administered to Patient that are in the Primary series"/>
            <a:s r="243">
               <a:s>/*
@internal: Seasonal influenza containing Doses Administered to Patient that are in the Primary series
*/
define &quot;Seasonal influenza Primary Series Doses Administered to Patient&quot;:
  </a:s>
               <a:s r="245">
                  <a:s r="244">
                     <a:s>&quot;Seasonal influenza 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="33:3-33:68" name="seriesPrimary" libraryName="Common" xsi:type="FunctionRef">
            <operand localId="244" locator="33:3-33:52" name="Seasonal influenza Doses Administered to Patient" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="248" locator="38:1-39:74" name="Number of Seasonal influenza Primary Series Doses Administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Number of Seasonal influenza Primary Series doses"/>
            <a:s r="248">
               <a:s>/*
@internal: Number of Seasonal influenza Primary Series doses
*/
define &quot;Number of Seasonal influenza Primary Series Doses Administered&quot;:
  </a:s>
               <a:s r="252">
                  <a:s>Count(</a:s>
                  <a:s r="249">
                     <a:s>&quot;Seasonal influenza Primary Series Doses Administered to Patient&quot;</a:s>
                  </a:s>
                  <a:s>)</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="252" locator="39:3-39:74" xsi:type="Count">
            <source localId="249" locator="39:9-39:73" name="Seasonal influenza Primary Series Doses Administered to Patient" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="255" locator="47:1-48:46" name="Client's age is less than 6 months" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client's age is less than 6 months"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; &lt; 6 months"/>
            <a:t name="code" value="Client's age is less than 6 months-41"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="255">
               <a:s>/*
@input: Client's age is less than 6 months
@pseudocode: Today's date − &quot;Date of birth&quot; &lt; 6 months
@code: Client's age is less than 6 months-41
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;Client's age is less than 6 months&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 Months&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="259"> &lt; 6</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="256" locator="48:3-48:46" 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="48:3-48:42" name="Current Patient Age In Months" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="259" locator="48:46" valueType="t:Integer" value="6" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="264" locator="56:1-57:70" name="No seasonal influenza primary series doses were administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="No seasonal influenza primary series doses were administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 0"/>
            <a:t name="code" value="No seasonal influenza primary series doses were administered-127"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="264">
               <a:s>/*
@input: No seasonal influenza primary series doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 0
@code: No seasonal influenza primary series doses were administered-127
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;No seasonal influenza primary series doses were administered&quot;:
  </a:s>
               <a:s r="265">
                  <a:s r="266">
                     <a:s>&quot;Number of Seasonal influenza 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="57:3-57:70" 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="57:3-57:66" name="Number of Seasonal influenza Primary Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="267" locator="57:70" valueType="t:Integer" value="0" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="272" locator="65:1-66:47" name="Client's age is more than or equal to 6 months" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client's age is more than or equal to 6 months"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; ≥ 6 months"/>
            <a:t name="code" value="Client's age is more than or equal to 6 months-41"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="272">
               <a:s>/*
@input: Client's age is more than or equal to 6 months
@pseudocode: Today's date − &quot;Date of birth&quot; ≥ 6 months
@code: Client's age is more than or equal to 6 months-41
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;Client's age is more than or equal to 6 months&quot;:
  </a:s>
               <a:s r="273">
                  <a:s r="275">
                     <a:s r="274">
                        <a:s>Elements</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="275">
                        <a:s>&quot;Current Patient Age In Months&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="276"> >= 6</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="273" locator="66:3-66:47" xsi:type="GreaterOrEqual">
            <signature localId="277" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="278" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="275" locator="66:3-66:42" name="Current Patient Age In Months" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="276" locator="66:47" valueType="t:Integer" value="6" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="281" locator="74:1-75:70" name="One seasonal influenza primary series doses were administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="One seasonal influenza primary series doses were administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 1"/>
            <a:t name="code" value="One seasonal influenza primary series doses were administered-127"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="281">
               <a:s>/*
@input: One seasonal influenza primary series doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 1
@code: One seasonal influenza primary series doses were administered-127
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;One seasonal influenza primary series doses were administered&quot;:
  </a:s>
               <a:s r="282">
                  <a:s r="283">
                     <a:s>&quot;Number of Seasonal influenza Primary Series Doses Administered&quot;</a:s>
                  </a:s>
                  <a:s r="284"> = 1</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="282" locator="75:3-75:70" xsi:type="Equal">
            <signature localId="285" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="286" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="283" locator="75:3-75:66" name="Number of Seasonal influenza Primary Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="284" locator="75:70" valueType="t:Integer" value="1" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="289" locator="83:1-84:45" name="Client's age is less than 9 years" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client's age is less than 9 years"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; &lt; 9 years"/>
            <a:t name="code" value="Client's age is less than 9 years-40"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="289">
               <a:s>/*
@input: Client's age is less than 9 years
@pseudocode: Today's date − &quot;Date of birth&quot; &lt; 9 years
@code: Client's age is less than 9 years-40
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;Client's age is less than 9 years&quot;:
  </a:s>
               <a:s r="290">
                  <a:s r="292">
                     <a:s r="291">
                        <a:s>Elements</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="292">
                        <a:s>&quot;Current Patient Age In Years&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="293"> &lt; 9</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="290" locator="84:3-84:45" xsi:type="Less">
            <signature localId="294" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="295" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="292" locator="84:3-84:41" name="Current Patient Age In Years" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="293" locator="84:45" valueType="t:Integer" value="9" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="302" locator="145:1-146:108" name="Date of Latest Seasonal influenza Dose" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="internal" value="Date of Latest Seasonal influenza Dose"/>
            <a:s r="302">
               <a:s>/*
@internal: Date of Latest Seasonal influenza Dose
*/
define &quot;Date of Latest Seasonal influenza Dose&quot;:
  </a:s>
               <a:s r="303">
                  <a:s>date from </a:s>
                  <a:s r="304">
                     <a:s>start of </a:s>
                     <a:s r="310">
                        <a:s r="309">
                           <a:s r="306">
                              <a:s r="305">
                                 <a:s>&quot;Seasonal influenza Doses Administered to Patient&quot;</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="306">
                                 <a:s>mostRecent()</a:s>
                              </a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="309">
                              <a:s>occurrence</a:s>
                           </a:s>
                        </a:s>
                        <a:s>.</a:s>
                        <a:s r="310">
                           <a:s>toInterval()</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="303" locator="146:3-146:108" xsi:type="DateFrom">
            <operand localId="304" locator="146:13-146:108" xsi:type="Start">
               <operand localId="310" locator="146:22-146:108" name="toInterval" libraryName="WC" xsi:type="FunctionRef">
                  <operand localId="309" locator="146:22-146:95" path="occurrence" xsi:type="Property">
                     <source localId="306" locator="146:22-146:84" name="mostRecent" libraryName="WC" xsi:type="FunctionRef">
                        <signature localId="307" xsi:type="ListTypeSpecifier">
                           <elementType localId="308" name="fhir:Immunization" xsi:type="NamedTypeSpecifier"/>
                        </signature>
                        <operand localId="305" locator="146:22-146:71" name="Seasonal influenza Doses Administered to Patient" xsi:type="ExpressionRef"/>
                     </source>
                  </operand>
               </operand>
            </operand>
         </expression>
      </def>
      <def localId="298" locator="92:1-94:86" name="The latest seasonal influenza dose was administered less than 4 weeks ago" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest seasonal influenza 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;Seasonal influenza vaccines&quot;) &lt; 4 weeks"/>
            <a:t name="code" value="The latest seasonal influenza dose was administered less than 4 weeks ago-110"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="298">
               <a:s>/*
@input: The latest seasonal influenza 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;Seasonal influenza vaccines&quot;) &lt; 4 weeks
@code: The latest seasonal influenza dose was administered less than 4 weeks ago-110
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;The latest seasonal influenza dose was administered less than 4 weeks ago&quot;:
  </a:s>
               <a:s r="299">
                  <a:s r="313">
                     <a:s r="311">
                        <a:s>&quot;Date of Latest Seasonal influenza Dose&quot;</a:s>
                     </a:s>
                     <a:s> is not null</a:s>
                  </a:s>
                  <a:s>
  and </a:s>
                  <a:s r="314">
                     <a:s r="315">
                        <a:s>duration in weeks between </a:s>
                        <a:s r="316">
                           <a:s>&quot;Date of Latest Seasonal influenza Dose&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="319">
                           <a:s>Now()</a:s>
                        </a:s>
                     </a:s>
                     <a:s r="325"> &lt; 4</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="299" locator="93:3-94:86" xsi:type="And">
            <operand localId="313" locator="93:3-93:54" xsi:type="Not">
               <operand localId="312" locator="93:3-93:54" xsi:type="IsNull">
                  <operand localId="311" locator="93:3-93:42" name="Date of Latest Seasonal influenza Dose" xsi:type="ExpressionRef"/>
               </operand>
            </operand>
            <operand localId="314" locator="94:7-94:86" xsi:type="Less">
               <signature localId="326" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="327" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="315" locator="94:7-94:82" precision="Week" xsi:type="DurationBetween">
                  <signature localId="323" name="t:DateTime" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="324" name="t:DateTime" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="321" xsi:type="ToDateTime">
                     <signature localId="322" name="t:Date" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="316" locator="94:33-94:72" name="Date of Latest Seasonal influenza Dose" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="319" locator="94:78-94:82" xsi:type="Now"/>
               </operand>
               <operand localId="325" locator="94:86" valueType="t:Integer" value="4" xsi:type="Literal"/>
            </operand>
         </expression>
      </def>
      <def localId="330" locator="102:1-103:81" name="The latest seasonal influenza dose was administered more than 4 weeks ago" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest seasonal influenza 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;Seasonal influenza vaccines&quot;) ≥ 4 weeks"/>
            <a:t name="code" value="The latest seasonal influenza dose was administered more than 4 weeks ago-110"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="330">
               <a:s>/*
@input: The latest seasonal influenza 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;Seasonal influenza vaccines&quot;) ≥ 4 weeks
@code: The latest seasonal influenza dose was administered more than 4 weeks ago-110
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;The latest seasonal influenza dose was administered more than 4 weeks ago&quot;:
  </a:s>
               <a:s r="331">
                  <a:s>not </a:s>
                  <a:s r="332">
                     <a:s>&quot;The latest seasonal influenza dose was administered less than 4 weeks ago&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="331" locator="103:3-103:81" xsi:type="Not">
            <operand localId="332" locator="103:7-103:81" name="The latest seasonal influenza dose was administered less than 4 weeks ago" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="335" locator="111:1-112:46" name="Client's age is more than or equal to 9 years" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Client's age is more than or equal to 9 years"/>
            <a:t name="pseudocode" value="&quot;Date of birth&quot; ≥ 9 years"/>
            <a:t name="code" value="Client's age is more than or equal to 9 years-40"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="335">
               <a:s>/*
@input: Client's age is more than or equal to 9 years
@pseudocode: Today's date − &quot;Date of birth&quot; ≥ 9 years
@code: Client's age is more than or equal to 9 years-40
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;Client's age is more than or equal to 9 years&quot;:
  </a:s>
               <a:s r="336">
                  <a:s r="338">
                     <a:s r="337">
                        <a:s>Elements</a:s>
                     </a:s>
                     <a:s>.</a:s>
                     <a:s r="338">
                        <a:s>&quot;Current Patient Age In Years&quot;</a:s>
                     </a:s>
                  </a:s>
                  <a:s r="339"> >= 9</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="336" locator="112:3-112:46" xsi:type="GreaterOrEqual">
            <signature localId="340" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="341" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="338" locator="112:3-112:41" name="Current Patient Age In Years" libraryName="Elements" xsi:type="ExpressionRef"/>
            <operand localId="339" locator="112:46" valueType="t:Integer" value="9" xsi:type="Literal"/>
         </expression>
      </def>
      <def localId="344" locator="120:1-122:86" name="The latest seasonal influenza dose was administered less than 1 year ago" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest seasonal influenza dose was administered less than 1 year ago"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot;) &lt; 1 year"/>
            <a:t name="code" value="The latest seasonal influenza dose was administered less than 1 year ago-109"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="344">
               <a:s>/*
@input: The latest seasonal influenza dose was administered less than 1 year ago
@pseudocode: Today's date − &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot;) &lt; 1 year
@code: The latest seasonal influenza dose was administered less than 1 year ago-109
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;The latest seasonal influenza dose was administered less than 1 year ago&quot;:
  </a:s>
               <a:s r="345">
                  <a:s r="348">
                     <a:s r="346">
                        <a:s>&quot;Date of Latest Seasonal influenza Dose&quot;</a:s>
                     </a:s>
                     <a:s> is not null</a:s>
                  </a:s>
                  <a:s>
  and </a:s>
                  <a:s r="349">
                     <a:s r="350">
                        <a:s>duration in years between </a:s>
                        <a:s r="351">
                           <a:s>&quot;Date of Latest Seasonal influenza Dose&quot;</a:s>
                        </a:s>
                        <a:s> and </a:s>
                        <a:s r="354">
                           <a:s>Now()</a:s>
                        </a:s>
                     </a:s>
                     <a:s r="360"> &lt; 1</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="345" locator="121:3-122:86" xsi:type="And">
            <operand localId="348" locator="121:3-121:54" xsi:type="Not">
               <operand localId="347" locator="121:3-121:54" xsi:type="IsNull">
                  <operand localId="346" locator="121:3-121:42" name="Date of Latest Seasonal influenza Dose" xsi:type="ExpressionRef"/>
               </operand>
            </operand>
            <operand localId="349" locator="122:7-122:86" xsi:type="Less">
               <signature localId="361" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <signature localId="362" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
               <operand localId="350" locator="122:7-122:82" precision="Year" xsi:type="DurationBetween">
                  <signature localId="358" name="t:DateTime" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="359" name="t:DateTime" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="356" xsi:type="ToDateTime">
                     <signature localId="357" name="t:Date" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="351" locator="122:33-122:72" name="Date of Latest Seasonal influenza Dose" xsi:type="ExpressionRef"/>
                  </operand>
                  <operand localId="354" locator="122:78-122:82" xsi:type="Now"/>
               </operand>
               <operand localId="360" locator="122:86" valueType="t:Integer" value="1" xsi:type="Literal"/>
            </operand>
         </expression>
      </def>
      <def localId="365" locator="130:1-131:80" name="The latest seasonal influenza dose was administered more than 1 year ago" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="The latest seasonal influenza dose was administered more than 1 year ago"/>
            <a:t name="pseudocode" value="&quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot;) ≥ 1 year"/>
            <a:t name="code" value="The latest seasonal influenza dose was administered more than 1 year ago-109"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="365">
               <a:s>/*
@input: The latest seasonal influenza dose was administered more than 1 year ago
@pseudocode: Today's date − &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot;) ≥ 1 year
@code: The latest seasonal influenza dose was administered more than 1 year ago-109
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;The latest seasonal influenza dose was administered more than 1 year ago&quot;:
  </a:s>
               <a:s r="366">
                  <a:s>not </a:s>
                  <a:s r="367">
                     <a:s>&quot;The latest seasonal influenza dose was administered less than 1 year ago&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="366" locator="131:3-131:80" xsi:type="Not">
            <operand localId="367" locator="131:7-131:80" name="The latest seasonal influenza dose was administered less than 1 year ago" xsi:type="ExpressionRef"/>
         </expression>
      </def>
      <def localId="370" locator="139:1-140:70" name="Two seasonal influenza primary series doses were administered" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="input" value="Two seasonal influenza primary series doses were administered"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 2"/>
            <a:t name="code" value="Two seasonal influenza primary series doses were administered-127"/>
            <a:t name="decision" value="IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule"/>
            <a:s r="370">
               <a:s>/*
@input: Two seasonal influenza primary series doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Seasonal influenza vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 2
@code: Two seasonal influenza primary series doses were administered-127
@decision: IMMZ.D2.DT.Seasonal influenza: Inactivated trivalent and quadrivalent vaccines, 2-dose schedule
*/
define &quot;Two seasonal influenza primary series doses were administered&quot;:
  </a:s>
               <a:s r="371">
                  <a:s r="372">
                     <a:s>&quot;Number of Seasonal influenza Primary Series Doses Administered&quot;</a:s>
                  </a:s>
                  <a:s r="373"> = 2</a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="371" locator="140:3-140:70" xsi:type="Equal">
            <signature localId="374" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <signature localId="375" name="t:Integer" xsi:type="NamedTypeSpecifier"/>
            <operand localId="372" locator="140:3-140:66" name="Number of Seasonal influenza Primary Series Doses Administered" xsi:type="ExpressionRef"/>
            <operand localId="373" locator="140:70" valueType="t:Integer" value="2" xsi:type="Literal"/>
         </expression>
      </def>
   </statements>
</library>
