WHO Immunization Implementation Guide
0.2.0 - ci-build
WHO Immunization Implementation Guide, published by WHO. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-immunizations/tree/123/merge and changes regularly. See the Directory of published versions
| Draft as of 2026-03-03 |
<PlanDefinition xmlns="http://hl7.org/fhir">
<id value="IMMZD18SMeaslesLowTransmission"/>
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value="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"/>
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<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<div>
<table class="grid dict">
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">IMMZD18SMeaslesLowTransmission</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD18SMeaslesLowTransmission.html">IMMZ.D18.S.Measles.Low transmission schedule</a></td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.2.0</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">IMMZ.D18.S.Measles.Low transmission schedule</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span><a href="http://terminology.hl7.org/7.0.1/CodeSystem-plan-definition-type.html">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>eca-rule</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2026-03-03 13:07:11+0000</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">WHO</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>IMMZ.D18.S.Measles.Low transmission schedule
Schedule for countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Knowledge Capability: </b></th>
<td style="padding-left: 4px;">
computable
</td>
</tr>
<tr>
<th scope="row"><b>Related Artifacts: </b></th>
<td style="padding-left: 4px;">
<p><b>References</b></p>
<ul>
<li><div><p>WHO recommendations for routine immunization - summary tables (January 2025)</p>
</div><br/><a href="null"/></li>
</ul>
</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-IMMZD18SMeaslesLowTransmissionLogic.html">IMMZD18SMeaslesLowTransmissionLogic</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Actions: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td>
<b> MCV dose 1 (MCV1):</b> Provision of MCV1 from the primary series
Trigger event: Child's birth
Trigger pseudo:
Trigger date: "Date of birth"
Create condition: The client is due for MCV1 if the client is at least 12 months
<br/>
<b>If:</b>
<i>Applicability:</i>
MCV dose 1 (MCV1)
<i>(MCV dose 1 (MCV1))</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTCR.html">IMMZ.D2.DT.CR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('active')</i>
<br/>
payload.contentString: <i>(MCV dose 1 (MCV1) Create)</i>
<br/>
category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>
<br/>
priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> MCV2:</b> Provision of MCV2 from the primary series
Trigger event: MCV1 was administered
Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Primary series") = 1
Trigger date: "Date of birth"
Create condition: The client is due for MCV2 if the client is at least 15 months.
<br/>
<b>If:</b>
<i>Applicability:</i>
MCV2
<i>(MCV2)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTCR.html">IMMZ.D2.DT.CR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('active')</i>
<br/>
payload.contentString: <i>(MCV2 Create)</i>
<br/>
category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>
<br/>
priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>
<br/>
</td>
</tr>
</table>
</td>
</tr>
</table>
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<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZElements"/>
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<extension url="name">
<valueString value="Doses Administered to Patient"/>
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<extension url="statement">
<valueString
value="/**
* @dataElement All Doses Administered to Patient
*/
define "Doses Administered to Patient":
[Immunization] I
where I.status = 'completed'
and I.isSubpotent is not true"/>
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<extension url="libraryName">
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<extension url="name">
<valueString value="MCV Doses Administered to Patient"/>
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<valueString
value="/*
@internal: MCV Doses Administered to Patient
*/
define "MCV Doses Administered to Patient":
Elements."Doses Administered to Patient" I
where
I.vaccineCode in Concepts."Measles-containing vaccines""/>
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<extension url="displaySequence">
<valueInteger value="1"/>
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<valueString value="IMMZD2DTMeaslesElements"/>
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<extension url="name">
<valueString
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<extension url="statement">
<valueString
value="/*
@internal: MCV Primary Series Doses Administered to Patient
*/
define "MCV Primary Series Doses Administered to Patient":
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<valueInteger value="2"/>
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<extension url="statement">
<valueString
value="/*
@internal: MCV Primary Series Doses Administered to Patient
*/
define "MCV Primary Series Doses Administered to Patient":
MeaslesElements."MCV Primary Series Doses Administered to Patient".onOrBefore(Today)"/>
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<extension url="displaySequence">
<valueInteger value="3"/>
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*/
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<extension url="name">
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<valueString
value="/*
@input: MCV2 was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Primary series") = 2
@code: MCV2 was administered-127
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)
*/
define "MCV2 was administered":
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@complete: MCV2 was administered. The primary series has been completed
@pseudocode: "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Measles-containing vaccines")
*/
define "MCV2 was administered. The primary series has been completed":
Encounter."MCV2 was administered""/>
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<extension
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@output: MCV2
@description: Provision of MCV2 from the primary series
@trigger: MCV1 was administered
@pseudo: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Primary series") = 1
@triggerDate: "Date of birth"
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<valueString value="MCV2 Due Date"/>
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@dynamicValue: MCV2 Due Date
@pseudocode: "Date of birth" + 15 months
*/
define "MCV2 Due Date":
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else null"/>
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@output: MCV2 Create
@create: The client is due for MCV2 if the client is at least 15 months.
*/
define "MCV2 Create":
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Due Date: ' + ToString("MCV2 Due Date")
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<extension
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<extension url="libraryName">
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<extension url="name">
<valueString
value="No measles primary series doses were administered"/>
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<extension url="statement">
<valueString
value="/*
@input: No measles primary series doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Primary series") = 0
@code: No measles primary series doses were administered-127
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)
*/
define "No measles primary series doses were administered":
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</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD18SMeaslesLowTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="MCV dose 1 (MCV1)"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: MCV dose 1 (MCV1)
@description: Provision of MCV1 from the primary series
@trigger: Child's birth
@pseudo:
@triggerDate: "Date of birth"
*/
define "MCV dose 1 (MCV1)":
Encounter."No measles primary series doses were administered""/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
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<extension
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<extension url="libraryName">
<valueString value="IMMZD18SMeaslesLowTransmissionLogic"/>
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<extension url="name">
<valueString value="MCV dose 1 (MCV1) Due Date"/>
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<extension url="statement">
<valueString
value="/*
@dynamicValue: MCV dose 1 (MCV1) Due Date
@pseudocode: "Date of birth" + 12 months
*/
define "MCV dose 1 (MCV1) Due Date":
if "MCV dose 1 (MCV1)" then Patient.birthDate + 12 months
else null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
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</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD18SMeaslesLowTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="MCV dose 1 (MCV1) Create"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: MCV dose 1 (MCV1) Create
@create: The client is due for MCV1 if the client is at least 12 months
*/
define "MCV dose 1 (MCV1) Create":
if "MCV dose 1 (MCV1)"
then 'The client is due for MCV1 if the client is at least 12 months' + '
Due Date: ' + ToString("MCV dose 1 (MCV1) Due Date")
else ''"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZCommon"/>
</extension>
<extension url="name">
<valueString value="onOrBefore"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @description: Gets immunizations on or before a date
*/
define fluent function onOrBefore(immunizations List<Immunization>, beforeDate Date):
immunizations I where
I.occurrence.toInterval() same day or before beforeDate"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
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<extension url="libraryName">
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<extension url="name">
<valueString value="seriesPrimary"/>
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<extension url="statement">
<valueString
value="/**
* @description: Gets the doses from the primary series
*/
define fluent function seriesPrimary(immunizations List<Immunization>):
immunizations I where
exists( I.protocolApplied pa where pa.series = 'Primary series' )"/>
</extension>
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<valueInteger value="15"/>
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<extension url="libraryName">
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System.Concept {
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}"/>
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<valueString value="ToDate"/>
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<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
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<code value="module-definition"/>
</coding>
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<display value="FHIR model information"/>
<resource
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</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Encounter"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZD2DTMeaslesEncounterElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Common"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library WC"/>
<resource
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<relatedArtifact>
<type value="depends-on"/>
<display value="Library MeaslesElements"/>
<resource
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<relatedArtifact>
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<resource
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<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource
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</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Concepts"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZConcepts"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Measles-containing vaccines"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE9"/>
</relatedArtifact>
<parameter>
<name value="Today"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="date"/>
</parameter>
<parameter>
<name value="MCV2"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="MCV2 Create"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
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<parameter>
<name value="MCV dose 1 (MCV1) Create"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
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<parameter>
<name value="MCV dose 1 (MCV1)"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<dataRequirement>
<type value="Immunization"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<mustSupport value="status"/>
<mustSupport value="isSubpotent"/>
</dataRequirement>
<dataRequirement>
<type value="Immunization"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<mustSupport value="status"/>
<mustSupport value="isSubpotent"/>
<mustSupport value="vaccineCode"/>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
</dataRequirement>
<dataRequirement>
<type value="Immunization"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<mustSupport value="status"/>
<mustSupport value="isSubpotent"/>
<mustSupport value="vaccineCode"/>
</dataRequirement>
<dataRequirement>
<type value="Immunization"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<mustSupport value="status"/>
<mustSupport value="isSubpotent"/>
<mustSupport value="vaccineCode"/>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
<valueCode value="computable"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
<valueCanonical value="#effective-data-requirements"/>
</extension>
<url
value="http://smart.who.int/immunizations/PlanDefinition/IMMZD18SMeaslesLowTransmission"/>
<version value="0.2.0"/>
<name value="IMMZD18SMeaslesLowTransmission"/>
<title value="IMMZ.D18.S.Measles.Low transmission schedule"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
<code value="eca-rule"/>
</coding>
</type>
<status value="draft"/>
<experimental value="false"/>
<date value="2026-03-03T13:07:11+00:00"/>
<publisher value="WHO"/>
<contact>
<name value="WHO"/>
<telecom>
<system value="url"/>
<value value="http://who.int"/>
</telecom>
</contact>
<description
value="IMMZ.D18.S.Measles.Low transmission schedule
Schedule for countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)"/>
<relatedArtifact>
<type value="citation"/>
<citation
value="WHO recommendations for routine immunization - summary tables (January 2025)"/>
</relatedArtifact>
<library
value="http://smart.who.int/immunizations/Library/IMMZD18SMeaslesLowTransmissionLogic"/>
<action>
<title value="MCV dose 1 (MCV1)"/>
<description
value="Provision of MCV1 from the primary series
Trigger event: Child's birth
Trigger pseudo:
Trigger date: "Date of birth"
Create condition: The client is due for MCV1 if the client is at least 12 months"/>
<condition>
<kind value="applicability"/>
<expression>
<description value="MCV dose 1 (MCV1)"/>
<language value="text/cql-identifier"/>
<expression value="MCV dose 1 (MCV1)"/>
</expression>
</condition>
<definitionCanonical
value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTCR"/>
<dynamicValue>
<path value="status"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'active'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="payload.contentString"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="MCV dose 1 (MCV1) Create"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="category.coding"/>
<expression>
<description value="Category of communication"/>
<language value="text/cql-expression"/>
<expression
value="Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="priority"/>
<expression>
<description value="Alert priority"/>
<language value="text/cql-expression"/>
<expression
value="Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }"/>
</expression>
</dynamicValue>
</action>
<action>
<title value="MCV2"/>
<description
value="Provision of MCV2 from the primary series
Trigger event: MCV1 was administered
Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Primary series") = 1
Trigger date: "Date of birth"
Create condition: The client is due for MCV2 if the client is at least 15 months."/>
<condition>
<kind value="applicability"/>
<expression>
<description value="MCV2"/>
<language value="text/cql-identifier"/>
<expression value="MCV2"/>
</expression>
</condition>
<definitionCanonical
value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTCR"/>
<dynamicValue>
<path value="status"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'active'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="payload.contentString"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="MCV2 Create"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="category.coding"/>
<expression>
<description value="Category of communication"/>
<language value="text/cql-expression"/>
<expression
value="Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="priority"/>
<expression>
<description value="Alert priority"/>
<language value="text/cql-expression"/>
<expression
value="Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }"/>
</expression>
</dynamicValue>
</action>
</PlanDefinition>