<?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="296">
         <a:s>/*
 * Library: IMMZ.IND.37 Logic
 * Drop-out rate from the 1st dose of measles and rubella-containing vaccine to the 2nd dose
 * The percentage in the target population who received a 1st dose of measles and rubella-containing vaccine in the primary series but have not received the 2nd dose of measles and rubella-containing vaccine in the primary series (i.e. are past due for measles and rubella-containing vaccine 2nd dose) during the reporting period
 * 
 * Numerator: Number of clients who received a 1st dose of measles and rubella-containing vaccine during the reporting period who should have received the 2nd dose of measles and rubella-containing vaccine during the reporting period but did not receive it
 * Numerator Computation: (COUNT of clients with an immunization event WHERE &quot;Vaccine type&quot;&quot; = &quot;Measles and rubella-containing vaccines&quot; for the 1st dose in the primary series AND &quot;Date and time of vaccination&quot; is during the reporting period) - (COUNT of clients with an immunization event WHERE &quot;Vaccine type&quot;&quot; = &quot;Measles and rubella-containing vaccines&quot; for the 2nd dose in the primary series AND &quot;Date and time of vaccination&quot; is during the reporting period)
 * Denominator: Number of clients in the target population who received dose 1 of measles and rubella-containing vaccine during the reporting period
 * Denominator Computation: COUNT clients with an immunization event WHERE &quot;Vaccine type&quot; = &quot;Measles and rubella-containing vaccines&quot; for a 1st dose in the primary series AND &quot;Date and time of vaccination&quot; is during the reporting period
 * 
 * Disaggregation
 *  - Administrative area
 *  - Sex
 *  - Age in years
 *  - Age group (depending on schedule)
 *
 * References: WHO Immunization facility analysis guide (5)
 * 
 * Annotations: –
 */
library IMMZIND37Logic</a:s>
      </a:s>
   </annotation>
   <identifier id="IMMZIND37Logic" 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="23:1-23:26" 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="25:1-25:35" 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="27:1-27:27" localIdentifier="WC" path="http://smart.who.int/immunizations/WHOCommon">
         <annotation xsi:type="a:Annotation">
            <a:s r="210">
               <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="212" locator="29:1-29:32" localIdentifier="Common" path="http://smart.who.int/immunizations/IMMZCommon">
         <annotation xsi:type="a:Annotation">
            <a:s r="212">
               <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="214" locator="30:1-30:36" localIdentifier="Concepts" path="http://smart.who.int/immunizations/IMMZConcepts">
         <annotation xsi:type="a:Annotation">
            <a:s r="214">
               <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="216" locator="31:1-31:45" localIdentifier="Elements" path="http://smart.who.int/immunizations/IMMZIndicatorElements">
         <annotation xsi:type="a:Annotation">
            <a:s r="216">
               <a:s>include </a:s>
               <a:s>
                  <a:s>IMMZIndicatorElements</a:s>
               </a:s>
               <a:s> called Elements</a:s>
            </a:s>
         </annotation>
      </def>
   </includes>
   <parameters>
      <def localId="218" locator="34:1-34:88" name="Measurement Period" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:s r="218">
               <a:s>parameter &quot;Measurement Period&quot; </a:s>
               <a:s r="230">
                  <a:s>Interval&lt;</a:s>
                  <a:s r="231">
                     <a:s>Date</a:s>
                  </a:s>
                  <a:s>></a:s>
               </a:s>
               <a:s> default </a:s>
               <a:s r="229">
                  <a:s r="223">Interval[@2025-01-01, @2025-12-31]</a:s>
               </a:s>
            </a:s>
         </annotation>
         <default localId="229" locator="34:55-34:88" lowClosed="true" highClosed="true" xsi:type="Interval">
            <low localId="223" locator="34:64-34:74" xsi:type="Date">
               <year localId="220" valueType="t:Integer" value="2025" xsi:type="Literal"/>
               <month localId="221" valueType="t:Integer" value="1" xsi:type="Literal"/>
               <day localId="222" valueType="t:Integer" value="1" xsi:type="Literal"/>
            </low>
            <high localId="228" locator="34:77-34:87" xsi:type="Date">
               <year localId="225" valueType="t:Integer" value="2025" xsi:type="Literal"/>
               <month localId="226" valueType="t:Integer" value="12" xsi:type="Literal"/>
               <day localId="227" valueType="t:Integer" value="31" xsi:type="Literal"/>
            </high>
         </default>
         <parameterTypeSpecifier localId="230" locator="34:32-34:45" xsi:type="IntervalTypeSpecifier">
            <pointType localId="231" locator="34:41-34:44" name="t:Date" xsi:type="NamedTypeSpecifier"/>
         </parameterTypeSpecifier>
      </def>
   </parameters>
   <contexts>
      <def localId="236" locator="36:1-36:15" name="Patient"/>
   </contexts>
   <statements>
      <def localId="234" locator="36:1-36:15" name="Patient" context="Patient">
         <expression localId="235" xsi:type="SingletonFrom">
            <operand localId="233" locator="36:1-36:15" dataType="fhir:Patient" templateId="http://hl7.org/fhir/StructureDefinition/Patient" xsi:type="Retrieve"/>
         </expression>
      </def>
      <def localId="239" locator="41:1-42:6" name="Initial Population" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:s r="239">
               <a:s r="240">/*
 * As defined by Member State
 */
define &quot;Initial Population&quot;:
  true</a:s>
            </a:s>
         </annotation>
         <expression localId="240" locator="42:3-42:6" valueType="t:Boolean" value="true" xsi:type="Literal"/>
      </def>
      <def localId="243" locator="49:1-51:65" name="Denominator" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="denominator" value="Number of clients in the target population who received dose 1 of measles and rubella-containing vaccine during the reporting period"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot; = &quot;Measles and rubella-containing vaccines&quot; for a 1st dose in the primary series AND &quot;Date and time of vaccination&quot; is during the reporting period"/>
            <a:t name="note" value="Updated to include those who have received the first dose and are due for the second during the measurement period"/>
            <a:s r="243">
               <a:s>/*
@denominator: Number of clients in the target population who received dose 1 of measles and rubella-containing vaccine during the reporting period
@pseudocode: COUNT clients with an immunization event WHERE &quot;Vaccine type&quot; = &quot;Measles and rubella-containing vaccines&quot; for a 1st dose in the primary series AND &quot;Date and time of vaccination&quot; is during the reporting period
@note: Updated to include those who have received the first dose and are due for the second during the measurement period
*/
define &quot;Denominator&quot;:
  </a:s>
               <a:s r="244">
                  <a:s r="245">
                     <a:s>exists</a:s>
                     <a:s r="250">
                        <a:s>( </a:s>
                        <a:s r="250">
                           <a:s r="247">
                              <a:s r="246">
                                 <a:s>Elements</a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="247">
                                 <a:s>&quot;Measles and Rubella Doses Administered to Patient&quot;</a:s>
                              </a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="250">
                              <a:s>getDose(</a:s>
                              <a:s r="248">
                                 <a:s>'1'</a:s>
                              </a:s>
                              <a:s>)</a:s>
                           </a:s>
                        </a:s>
                        <a:s> )</a:s>
                     </a:s>
                  </a:s>
                  <a:s>
    and </a:s>
                  <a:s r="263">
                     <a:s r="254">
                        <a:s r="256">
                           <a:s r="255">
                              <a:s>Patient</a:s>
                           </a:s>
                           <a:s>.</a:s>
                           <a:s r="256">
                              <a:s>birthDate</a:s>
                           </a:s>
                        </a:s>
                        <a:s> + </a:s>
                        <a:s r="257">
                           <a:s>15 months</a:s>
                        </a:s>
                     </a:s>
                     <a:s r="263"> during </a:s>
                     <a:s r="261">
                        <a:s>&quot;Measurement Period&quot;</a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="244" locator="50:3-51:65" xsi:type="And">
            <operand localId="245" locator="50:3-50:85" xsi:type="Exists">
               <operand localId="250" locator="50:9-50:85" name="getDose" libraryName="Common" xsi:type="FunctionRef">
                  <signature localId="251" xsi:type="ListTypeSpecifier">
                     <elementType localId="252" name="fhir:Immunization" xsi:type="NamedTypeSpecifier"/>
                  </signature>
                  <signature localId="253" name="t:String" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="247" locator="50:11-50:70" name="Measles and Rubella Doses Administered to Patient" libraryName="Elements" xsi:type="ExpressionRef"/>
                  <operand localId="248" locator="50:80-50:82" valueType="t:String" value="1" xsi:type="Literal"/>
               </operand>
            </operand>
            <operand localId="263" locator="51:9-51:65" xsi:type="In">
               <operand localId="254" locator="51:9-51:37" xsi:type="Add">
                  <signature localId="259" name="t:Date" xsi:type="NamedTypeSpecifier"/>
                  <signature localId="260" name="t:Quantity" xsi:type="NamedTypeSpecifier"/>
                  <operand localId="258" name="ToDate" libraryName="FHIRHelpers" xsi:type="FunctionRef">
                     <operand localId="256" locator="51:9-51:25" path="birthDate" xsi:type="Property">
                        <source localId="255" locator="51:9-51:15" name="Patient" xsi:type="ExpressionRef"/>
                     </operand>
                  </operand>
                  <operand localId="257" locator="51:29-51:37" value="15" unit="months" xsi:type="Quantity"/>
               </operand>
               <operand localId="261" locator="51:46-51:65" name="Measurement Period" xsi:type="ParameterRef"/>
            </operand>
         </expression>
      </def>
      <def localId="266" locator="59:1-61:119" name="Numerator" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="numerator" value="Number of clients who received a 1st dose of measles and rubella-containing vaccine during the reporting period who should have received the 2nd dose of measles and rubella-containing vaccine during the reporting period but did not receive it"/>
            <a:t name="pseudocode" value="&quot;Vaccine type&quot;&quot; = &quot;Measles and rubella-containing vaccines&quot; for the 1st dose in the primary series AND &quot;Date and time of vaccination&quot; is during the reporting period) - (COUNT of clients with an immunization event WHERE &quot;Vaccine type&quot;&quot; = &quot;Measles and rubella-containing vaccines&quot; for the 2nd dose in the primary series AND &quot;Date and time of vaccination&quot; is during the reporting period)"/>
            <a:t name="note" value="Only include those from the denominator that did not receive a measles/rubella 2nd dose during the measurement period.&#xa;        Those where the 2nd dose due date is during the period but have not received the 2nd dose."/>
            <a:s r="266">
               <a:s>/*
@numerator: Number of clients who received a 1st dose of measles and rubella-containing vaccine during the reporting period who should have received the 2nd dose of measles and rubella-containing vaccine during the reporting period but did not receive it
@pseudocode: (COUNT of clients with an immunization event WHERE &quot;Vaccine type&quot;&quot; = &quot;Measles and rubella-containing vaccines&quot; for the 1st dose in the primary series AND &quot;Date and time of vaccination&quot; is during the reporting period) - (COUNT of clients with an immunization event WHERE &quot;Vaccine type&quot;&quot; = &quot;Measles and rubella-containing vaccines&quot; for the 2nd dose in the primary series AND &quot;Date and time of vaccination&quot; is during the reporting period)
@note: Only include those from the denominator that did not receive a measles/rubella 2nd dose during the measurement period.
        Those where the 2nd dose due date is during the period but have not received the 2nd dose.
*/
define &quot;Numerator&quot;:
  </a:s>
               <a:s r="267">
                  <a:s r="268">
                     <a:s>&quot;Denominator&quot;</a:s>
                  </a:s>
                  <a:s>
  and </a:s>
                  <a:s r="269">
                     <a:s>not </a:s>
                     <a:s r="270">
                        <a:s>exists</a:s>
                        <a:s r="275">
                           <a:s>( </a:s>
                           <a:s r="275">
                              <a:s r="272">
                                 <a:s r="271">
                                    <a:s>Elements</a:s>
                                 </a:s>
                                 <a:s>.</a:s>
                                 <a:s r="272">
                                    <a:s>&quot;Measles and Rubella Doses Administered to Patient During Measurement Period&quot;</a:s>
                                 </a:s>
                              </a:s>
                              <a:s>.</a:s>
                              <a:s r="275">
                                 <a:s>getDose(</a:s>
                                 <a:s r="273">
                                    <a:s>'2'</a:s>
                                 </a:s>
                                 <a:s>)</a:s>
                              </a:s>
                           </a:s>
                           <a:s> )</a:s>
                        </a:s>
                     </a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="267" locator="60:3-61:119" xsi:type="And">
            <operand localId="268" locator="60:3-60:15" name="Denominator" xsi:type="ExpressionRef"/>
            <operand localId="269" locator="61:7-61:119" xsi:type="Not">
               <operand localId="270" locator="61:11-61:119" xsi:type="Exists">
                  <operand localId="275" locator="61:17-61:119" name="getDose" libraryName="Common" xsi:type="FunctionRef">
                     <signature localId="276" xsi:type="ListTypeSpecifier">
                        <elementType localId="277" name="fhir:Immunization" xsi:type="NamedTypeSpecifier"/>
                     </signature>
                     <signature localId="278" name="t:String" xsi:type="NamedTypeSpecifier"/>
                     <operand localId="272" locator="61:19-61:104" name="Measles and Rubella Doses Administered to Patient During Measurement Period" libraryName="Elements" xsi:type="ExpressionRef"/>
                     <operand localId="273" locator="61:114-61:116" valueType="t:String" value="2" xsi:type="Literal"/>
                  </operand>
               </operand>
            </operand>
         </expression>
      </def>
      <def localId="281" locator="69:1-70:43" name="Stratification 1" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:t name="disaggregation" value="Administrative area&#xa;                 Sex&#xa;                 Age in years&#xa;                 Age group (depending on schedule)"/>
            <a:s r="281">
               <a:s>/*
@disaggregation: Administrative area
                 Sex
                 Age in years
                 Age group (depending on schedule)
*/
define &quot;Stratification 1&quot;:
	</a:s>
               <a:s r="283">
                  <a:s r="282">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="283">
                     <a:s>&quot;By Geographic Region Stratifier&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="283" locator="70:2-70:43" name="By Geographic Region Stratifier" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
      <def localId="286" locator="72:1-73:47" name="Stratification 2" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:s r="286">
               <a:s>define &quot;Stratification 2&quot;:
	</a:s>
               <a:s r="288">
                  <a:s r="287">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="288">
                     <a:s>&quot;By Administrative Gender Stratifier&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="288" locator="73:2-73:47" name="By Administrative Gender Stratifier" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
      <def localId="291" locator="75:1-76:26" name="Stratification 3" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:s r="291">
               <a:s>define &quot;Stratification 3&quot;:
	</a:s>
               <a:s r="293">
                  <a:s r="292">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="293">
                     <a:s>&quot;Age Stratifier&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="293" locator="76:2-76:26" name="Age Stratifier" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
      <def localId="296" locator="78:1-79:37" name="Stratification 4" context="Patient" accessLevel="Public">
         <annotation xsi:type="a:Annotation">
            <a:s r="296">
               <a:s>define &quot;Stratification 4&quot;:
	</a:s>
               <a:s r="298">
                  <a:s r="297">
                     <a:s>Elements</a:s>
                  </a:s>
                  <a:s>.</a:s>
                  <a:s r="298">
                     <a:s>&quot;Toddler By Age Stratifier&quot;</a:s>
                  </a:s>
               </a:s>
            </a:s>
         </annotation>
         <expression localId="298" locator="79:2-79:37" name="Toddler By Age Stratifier" libraryName="Elements" xsi:type="ExpressionRef"/>
      </def>
   </statements>
</library>
