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="IMMZD2DTDTPDelayedOrInterruptedSeries"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"/>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareableplandefinition"/>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishableplandefinition"/>
</meta>
<text>
<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;">IMMZD2DTDTPDelayedOrInterruptedSeries</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD2DTDTPDelayedOrInterruptedSeries.html">IMMZ.D2.DT.DTP.Delayed or interrupted series</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.D2.DT.DTP.Delayed or interrupted series</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.D2.DT.DTP.Delayed or interrupted series
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age</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-IMMZD2DTDTPDelayedOrInterruptedSeriesLogic.html">IMMZD2DTDTPDelayedOrInterruptedSeriesLogic</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> Determine if the client is due for DTP.:</b> Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
<br/>
<b>If:</b>
<i>Applicability:</i>
Client is due for DTP vaccination
<i>(Client is due for DTP vaccination)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTMR.html">IMMZD2DTMR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('draft')</i>
<br/>
intent: <i>('proposal')</i>
<br/>
medication: <i>(Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE24', display: 'DTP-containing vaccines' } }, display: 'DTP-containing vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Determine if the client is due for DTP.:</b> Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
<br/>
<b>If:</b>
<i>Applicability:</i>
Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose
<i>(Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTMR.html">IMMZD2DTMR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('draft')</i>
<br/>
intent: <i>('proposal')</i>
<br/>
medication: <i>(Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE28', display: 'Tetanus and diphtheria-containing vaccines' } }, display: 'Tetanus and diphtheria-containing vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Determine if the client is due for DTP.:</b> Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
<br/>
<b>If:</b>
<i>Applicability:</i>
Client is due for tetanus and diphtheria booster dose
<i>(Client is due for tetanus and diphtheria booster dose)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTMR.html">IMMZD2DTMR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('draft')</i>
<br/>
intent: <i>('proposal')</i>
<br/>
medication: <i>(Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE28', display: 'Tetanus and diphtheria-containing vaccines' } }, display: 'Tetanus and diphtheria-containing vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Determine if the client is due for DTP.:</b> Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
<br/>
<b>If:</b>
<i>Applicability:</i>
Primary DTP series is complete. Client is due for pertussis booster dose
<i>(Primary DTP series is complete. Client is due for pertussis booster dose)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTMR.html">IMMZD2DTMR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('draft')</i>
<br/>
intent: <i>('proposal')</i>
<br/>
medication: <i>(Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE12', display: 'Pertussis-containing vaccines' } }, display: 'Pertussis-containing vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Check for Guidance for the patient regarding IMMZ.D2.DT.DTP.Delayed or interrupted series.:</b> Show Guidance for the patient regarding IMMZ.D2.DT.DTP.Delayed or interrupted series.
<br/>
<b>If:</b>
<i>Applicability:</i>
Has Guidance
<i>(Has Guidance)</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>(Guidance)</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>
</div>
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<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZElements"/>
</extension>
<extension url="name">
<valueString value="Doses Administered to Patient"/>
</extension>
<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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPElements"/>
</extension>
<extension url="name">
<valueString value="DTP Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: DTP containing Doses Administered to Patient
*/
define "DTP Doses Administered to Patient":
Elements."Doses Administered to Patient" I
where
I.vaccineCode in Concepts."DTP-containing vaccines""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPElements"/>
</extension>
<extension url="name">
<valueString
value="DTP Primary Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: DTP containing Doses Administered to Patient that are in the Primary series
*/
define "DTP Primary Series Doses Administered to Patient":
"DTP Doses Administered to Patient".seriesPrimary()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="DTP Primary Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: DTP containing Doses Administered to Patient that are in the Primary series
*/
define "DTP Primary Series Doses Administered to Patient":
DTPElements."DTP Primary Series Doses Administered to Patient".onOrBefore(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Number of DTP Primary Series Doses Administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Number of DTP Primary Series doses
*/
define "Number of DTP Primary Series Doses Administered":
Count("DTP Primary Series Doses Administered to Patient")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Three DTP primary series doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Three DTP primary series doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "DTP-containing vaccines" and "Type of dose" = "Primary series") = 3
@code: Three DTP primary series doses were administered-123
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
@decision: IMMZ.D2.DT.DTP.Pregnancy: Determine whether DTP-containing vaccines are needed for pregnant women
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 3 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 3 childhood DTP doses
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 4 childhood DTP doses
*/
define "Three DTP primary series doses were administered":
"Number of DTP Primary Series Doses Administered" = 3"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPElements"/>
</extension>
<extension url="name">
<valueString value="Td Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Td Doses Administered to Patient
*/
define "Td Doses Administered to Patient":
Elements."Doses Administered to Patient" I
where
I.vaccineCode in Concepts."Tetanus and diphtheria-containing vaccines""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPElements"/>
</extension>
<extension url="name">
<valueString
value="Td Booster Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Td Booster Series Doses Administered to Patient
*/
define "Td Booster Series Doses Administered to Patient":
"Td Doses Administered to Patient".seriesBooster()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Td Booster Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Td Booster Series Doses Administered to Patient
*/
define "Td Booster Series Doses Administered to Patient":
DTPElements."Td Booster Series Doses Administered to Patient".onOrBefore(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Number of Td Booster Series Doses Administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Number of Td Booster Series Doses Administered
*/
define "Number of Td Booster Series Doses Administered":
Count("Td Booster Series Doses Administered to Patient")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="No tetanus and diphtheria booster doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No tetanus and diphtheria booster doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines" and "Type of dose" = "Booster dose") = 0
@code: No tetanus and diphtheria booster doses were administered-140
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 3 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 3 childhood DTP doses
*/
define "No tetanus and diphtheria booster doses were administered":
"Number of Td Booster Series Doses Administered" = 0"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="DTP Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: DTP containing Doses Administered to Patient
*/
define "DTP Doses Administered to Patient":
DTPElements."DTP Doses Administered to Patient".onOrBefore(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Date of Latest DTP Dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Date of Latest DTP Dose
*/
define "Date of Latest DTP Dose":
date from start of "DTP Doses Administered to Patient".mostRecent().occurrence.toInterval()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest DTP dose was administered less than 1 year ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest DTP dose was administered less than 1 year ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines") < 1 year
@code: The latest DTP dose was administered less than 1 year ago-112
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "The latest DTP dose was administered less than 1 year ago":
"Date of Latest DTP Dose" is not null
and duration in years between "Date of Latest DTP Dose" and Today < 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose
@pseudocode: "Immunization recommendation status" = "Not due" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines")
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose":
Encounter."Three DTP primary series doses were administered"
and Encounter."No tetanus and diphtheria booster doses were administered"
and Encounter."The latest DTP dose was administered less than 1 year ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPElements"/>
</extension>
<extension url="name">
<valueString value="Pertussis Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Pertussis Doses Administered to Patient
*/
define "Pertussis Doses Administered to Patient":
Elements."Doses Administered to Patient" I
where
I.vaccineCode in Concepts."Pertussis-containing vaccines""/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPElements"/>
</extension>
<extension url="name">
<valueString
value="Pertussis Booster Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Pertussis Booster Series Doses Administered to Patient
*/
define "Pertussis Booster Series Doses Administered to Patient":
"Pertussis Doses Administered to Patient".seriesBooster()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Pertussis Booster Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Pertussis Booster Series Doses Administered to Patient
*/
define "Pertussis Booster Series Doses Administered to Patient":
DTPElements."Pertussis Booster Series Doses Administered to Patient".onOrBefore(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Number of Pertussis Booster Series Doses Administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Number of Pertussis Booster Series Doses Administered
*/
define "Number of Pertussis Booster Series Doses Administered":
Count("Pertussis Booster Series Doses Administered to Patient")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="No pertussis booster doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No pertussis booster doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Pertussis-containing vaccines" and "Type of dose" = "Booster dose") = 0
@code: No pertussis booster doses were administered-127
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "No pertussis booster doses were administered":
"Number of Pertussis Booster Series Doses Administered" = 0"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Current Patient Age In Years"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @dataElement Patient age in years
*/
define "Current Patient Age In Years":
AgeInYearsAt(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Client's age is between 1 year and 6 years"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is between 1 year and 6 years
@pseudocode: 1 year ≤ Today's date − "Date of birth" ≤ 6 years
@code: Client's age is between 1 year and 6 years-49
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "Client's age is between 1 year and 6 years":
1 <= Encounter."Current Patient Age In Years"
and Encounter."Current Patient Age In Years" <= 6"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest DTP dose was administered less than 6 months ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest DTP dose was administered less than 6 months ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines") < 6 months
@code: The latest DTP dose was administered less than 6 months ago-114
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "The latest DTP dose was administered less than 6 months ago":
"Date of Latest DTP Dose" is not null
and duration in months between "Date of Latest DTP Dose" and Today < 6"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Primary DTP series is complete. Client is not due for pertussis booster dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary DTP series is complete. Client is not due for pertussis booster dose
@pseudocode: "Immunization recommendation status" = "Not due" (where "Vaccine type" = "Pertussis-containing vaccines")
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Primary DTP series is complete. Client is not due for pertussis booster dose":
Encounter."Three DTP primary series doses were administered"
and Encounter."No pertussis booster doses were administered"
and Encounter."Client's age is between 1 year and 6 years"
and Encounter."The latest DTP dose was administered less than 6 months ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose Guidance
@guidance: Should not vaccinate client with first tetanus and diphtheria booster dose as the latest DTP dose was administered less than 1 year ago.
Check for any other vaccines due and inform the caregiver of when to come back for first tetanus and diphtheria booster dose.
*/
define "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose Guidance":
'Should not vaccinate client with first tetanus and diphtheria booster dose as the latest DTP dose was administered less than 1 year ago.
Check for any other vaccines due and inform the caregiver of when to come back for first tetanus and diphtheria booster dose.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Primary DTP series is complete. Client is not due for pertussis booster dose Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary DTP series is complete. Client is not due for pertussis booster dose Guidance
@guidance: Should not vaccinate client with pertussis booster dose as the latest DTP dose was administered less than 6 months ago.
Check for any other vaccines due and inform the caregiver of when to come back for pertussis booster dose.
*/
define "Primary DTP series is complete. Client is not due for pertussis booster dose Guidance":
'Should not vaccinate client with pertussis booster dose as the latest DTP dose was administered less than 6 months ago.
Check for any other vaccines due and inform the caregiver of when to come back for pertussis booster dose.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest DTP dose was administered more than 6 months ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest DTP dose was administered more than 6 months ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines") ≥ 6 months
@code: The latest DTP dose was administered more than 6 months ago-114
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "The latest DTP dose was administered more than 6 months ago":
not("The latest DTP dose was administered less than 6 months ago")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Primary DTP series is complete. Client is due for pertussis booster dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary DTP series is complete. Client is due for pertussis booster dose
@pseudocode: "Immunization recommendation status" = "Due" (where "Vaccine type" = "Pertussis-containing vaccines")
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Primary DTP series is complete. Client is due for pertussis booster dose":
Encounter."Three DTP primary series doses were administered"
and Encounter."No pertussis booster doses were administered"
and Encounter."Client's age is between 1 year and 6 years"
and Encounter."The latest DTP dose was administered more than 6 months ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Primary DTP series is complete. Client is due for pertussis booster dose Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary DTP series is complete. Client is due for pertussis booster dose Guidance
@guidance: Should vaccinate client with pertussis booster dose as no pertussis booster doses were administered, client is within appropriate age range and the latest DTP dose was administered more than 6 months ago.
Check for contraindications.
*/
define "Primary DTP series is complete. Client is due for pertussis booster dose Guidance":
'Should vaccinate client with pertussis booster dose as no pertussis booster doses were administered, client is within appropriate age range and the latest DTP dose was administered more than 6 months ago.
Check for contraindications.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Client's age is more than 6 years"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is more than 6 years
@pseudocode: Today's date − "Date of birth" > 6 years
@code: Client's age is more than 6 years-40
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "Client's age is more than 6 years":
Encounter."Current Patient Age In Years" > 6"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Pertussis immunization schedule is complete Case 1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Pertussis immunization schedule is complete Case 1
@pseudocode: "Immunization recommendation status" = "Complete" (where "Vaccine type" = "Pertussis-containing vaccines")
*/
define "Pertussis immunization schedule is complete Case 1":
Encounter."Three DTP primary series doses were administered"
and Encounter."No pertussis booster doses were administered"
and Encounter."Client's age is more than 6 years""/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="One pertussis booster dose was administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: One pertussis booster dose was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Pertussis-containing vaccines" and "Type of dose" = "Booster dose") = 1
@code: One pertussis booster dose was administered-127
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "One pertussis booster dose was administered":
"Number of Pertussis Booster Series Doses Administered" = 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Pertussis immunization schedule is complete Case 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Pertussis immunization schedule is complete Case 2
@pseudocode: "Immunization recommendation status" = "Complete" (where "Vaccine type" = "Pertussis-containing vaccines")
*/
define "Pertussis immunization schedule is complete Case 2":
Encounter."Three DTP primary series doses were administered"
and Encounter."One pertussis booster dose was administered""/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Pertussis immunization schedule is complete"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Pertussis immunization schedule is complete
@pseudocode: "Immunization recommendation status" = "Complete" (where "Vaccine type" = "Pertussis-containing vaccines")
*/
define "Pertussis immunization schedule is complete":
"Pertussis immunization schedule is complete Case 1"
or "Pertussis immunization schedule is complete Case 2""/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Pertussis immunization schedule is complete Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Pertussis immunization schedule is complete Guidance
@guidance = Pertussis immunization schedule is complete. Three DTP primary series doses were administered.
Check for any other vaccines due.
@guidance = Pertussis immunization schedule is complete. Three DTP primary series doses and one pertussis booster dose were administered.
Check for any other vaccines due.
*/
define "Pertussis immunization schedule is complete Guidance":
case
when "Pertussis immunization schedule is complete Case 1" then 'Pertussis immunization schedule is complete. Three DTP primary series doses were administered.
Check for any other vaccines due.'
when "Pertussis immunization schedule is complete Case 2" then 'Pertussis immunization schedule is complete. Three DTP primary series doses and one pertussis booster dose were administered.
Check for any other vaccines due.'
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest DTP dose was administered more than 1 year ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest DTP dose was administered more than 1 year ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines") ≥ 1 year
@code: The latest DTP dose was administered more than 1 year ago-112
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "The latest DTP dose was administered more than 1 year ago":
not("The latest DTP dose was administered less than 1 year ago")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose
@pseudocode: "Immunization recommendation status" = "Due" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines")
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose":
Encounter."Three DTP primary series doses were administered"
and Encounter."No tetanus and diphtheria booster doses were administered"
and Encounter."The latest DTP dose was administered more than 1 year ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose Guidance
@guidance: Should vaccinate client with first tetanus and diphtheria booster dose as the latest DTP dose was administered more than 1 year ago.
Check for contraindications.
*/
define "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose Guidance":
'Should vaccinate client with first tetanus and diphtheria booster dose as the latest DTP dose was administered more than 1 year ago.
Check for contraindications.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="One tetanus and diphtheria booster dose was administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: One tetanus and diphtheria booster dose was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines" and "Type of dose" = "Booster dose") = 1
@code: One tetanus and diphtheria booster dose was administered-140
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
@decision: IMMZ.D2.DT.DTP.Pregnancy: Determine whether DTP-containing vaccines are needed for pregnant women
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 4 childhood DTP doses
*/
define "One tetanus and diphtheria booster dose was administered":
"Number of Td Booster Series Doses Administered" = 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Td Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Td Doses Administered to Patient
*/
define "Td Doses Administered to Patient":
DTPElements."Td Doses Administered to Patient".onOrBefore(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="39"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Date of Latest Td Dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Date of Latest Td Dose
*/
define "Date of Latest Td Dose":
date from start of "Td Doses Administered to Patient".mostRecent().occurrence.toInterval()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="40"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest tetanus and diphtheria dose was administered less than 1 year ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest tetanus and diphtheria dose was administered less than 1 year ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines") < 1 year
@code: The latest tetanus and diphtheria dose was administered less than 1 year ago-131
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 3 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 3 childhood DTP doses
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 4 childhood DTP doses
*/
define "The latest tetanus and diphtheria dose was administered less than 1 year ago":
"Date of Latest Td Dose" is not null
and duration in years between "Date of Latest Td Dose" and Today < 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="41"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for tetanus and diphtheria booster dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for tetanus and diphtheria booster dose
@pseudocode: "Immunization recommendation status" = "Not due" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines")
*/
define "Client is not due for tetanus and diphtheria booster dose":
Encounter."Three DTP primary series doses were administered"
and Encounter."One tetanus and diphtheria booster dose was administered"
and Encounter."The latest tetanus and diphtheria dose was administered less than 1 year ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="42"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for tetanus and diphtheria booster dose Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for tetanus and diphtheria booster dose Guidance
@guidance: Should not vaccinate client with second tetanus and diphtheria booster dose as the latest tetanus and diphtheria dose was administered less than 1 year ago.
Check for any other vaccines due and inform the caregiver of when to come back for second tetanus and diphtheria booster dose.
*/
define "Client is not due for tetanus and diphtheria booster dose Guidance":
'Should not vaccinate client with second tetanus and diphtheria booster dose as the latest tetanus and diphtheria dose was administered less than 1 year ago.
Check for any other vaccines due and inform the caregiver of when to come back for second tetanus and diphtheria booster dose.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="43"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest tetanus and diphtheria dose was administered more than 1 year ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest tetanus and diphtheria dose was administered more than 1 year ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines") ≥ 1 year
@code: The latest tetanus and diphtheria dose was administered more than 1 year ago-131
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 3 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 3 childhood DTP doses
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 4 childhood DTP doses
*/
define "The latest tetanus and diphtheria dose was administered more than 1 year ago":
not("The latest tetanus and diphtheria dose was administered less than 1 year ago")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="44"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is due for tetanus and diphtheria booster dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for tetanus and diphtheria booster dose
@pseudocode: "Immunization recommendation status" = "Due" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines")
*/
define "Client is due for tetanus and diphtheria booster dose":
Encounter."Three DTP primary series doses were administered"
and Encounter."One tetanus and diphtheria booster dose was administered"
and Encounter."The latest tetanus and diphtheria dose was administered more than 1 year ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="45"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is due for tetanus and diphtheria booster dose Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for tetanus and diphtheria booster dose Guidance
@guidance: Should vaccinate client with second tetanus and diphtheria booster dose as the latest tetanus and diphtheria dose was administered more than 1 year ago.
Check for contraindications.
*/
define "Client is due for tetanus and diphtheria booster dose Guidance":
'Should vaccinate client with second tetanus and diphtheria booster dose as the latest tetanus and diphtheria dose was administered more than 1 year ago.
Check for contraindications.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="46"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Two tetanus and diphtheria booster doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Two tetanus and diphtheria booster doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines" and "Type of dose" = "Booster dose") = 2
@code: Two tetanus and diphtheria booster doses were administered-140
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
@decision: IMMZ.D2.DT.DTP.Pregnancy: Determine whether DTP-containing vaccines are needed for pregnant women
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 3 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 3 childhood DTP doses
@decision: IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses: Diphtheria and tetanus vaccination schedule in pregnant women who received 4 childhood DTP doses
*/
define "Two tetanus and diphtheria booster doses were administered":
"Number of Td Booster Series Doses Administered" = 2"/>
</extension>
<extension url="displaySequence">
<valueInteger value="47"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Tetanus and diphtheria immunization schedule is complete"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Tetanus and diphtheria immunization schedule is complete
@pseudocode: "Immunization recommendation status" = "Complete" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines")
*/
define "Tetanus and diphtheria immunization schedule is complete":
Encounter."Three DTP primary series doses were administered"
and Encounter."Two tetanus and diphtheria booster doses were administered""/>
</extension>
<extension url="displaySequence">
<valueInteger value="48"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Tetanus and diphtheria immunization schedule is complete Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Tetanus and diphtheria immunization schedule is complete Guidance
@guidance: Tetanus and diphtheria immunization schedule is complete. Three DTP primary series doses and two tetanus and diphtheria booster doses were administered.
Check for any other vaccines due.
*/
define "Tetanus and diphtheria immunization schedule is complete Guidance":
'Tetanus and diphtheria immunization schedule is complete. Three DTP primary series doses and two tetanus and diphtheria booster doses were administered.
Check for any other vaccines due.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="49"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="No DTP primary series doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No DTP primary series doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "DTP-containing vaccines" and "Type of dose" = "Primary series") = 0
@code: No DTP primary series doses were administered-123
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
@decision: IMMZ.D2.DT.DTP.Pregnancy: Determine whether DTP-containing vaccines are needed for pregnant women
*/
define "No DTP primary series doses were administered":
"Number of DTP Primary Series Doses Administered" = 0"/>
</extension>
<extension url="displaySequence">
<valueInteger value="50"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Client's age is more than 1 year"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is more than 1 year
@pseudocode: Today's date − "Date of birth" > 1 year
@code: Client's age is more than 1 year-39
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "Client's age is more than 1 year":
Encounter."Current Patient Age In Years" >= 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="51"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for DTP vaccination Case 1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for DTP vaccination Case 1
@pseudocode: "Immunization recommendation status" = "Due" (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Client is due for DTP vaccination Case 1":
Encounter."No DTP primary series doses were administered"
and Encounter."Client's age is more than 1 year""/>
</extension>
<extension url="displaySequence">
<valueInteger value="52"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString value="One DTP primary series dose was administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: One DTP primary series dose was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "DTP-containing vaccines" and "Type of dose" = "Primary series") = 1
@code: One DTP primary series dose was administered-123
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "One DTP primary series dose was administered":
"Number of DTP Primary Series Doses Administered" = 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="53"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest DTP dose was administered less than 4 weeks ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest DTP dose was administered less than 4 weeks ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines") < 4 weeks
@code: The latest DTP dose was administered less than 4 weeks ago-113
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "The latest DTP dose was administered less than 4 weeks ago":
"Date of Latest DTP Dose" is not null
and duration in weeks between "Date of Latest DTP Dose" and Today < 4"/>
</extension>
<extension url="displaySequence">
<valueInteger value="54"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest DTP dose was administered more than 4 weeks ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest DTP dose was administered more than 4 weeks ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines") ≥ 4 weeks
@code: The latest DTP dose was administered more than 4 weeks ago-113
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "The latest DTP dose was administered more than 4 weeks ago":
not("The latest DTP dose was administered less than 4 weeks ago")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="55"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for DTP vaccination Case 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for DTP vaccination Case 2
@pseudocode: "Immunization recommendation status" = "Due" (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Client is due for DTP vaccination Case 2":
Encounter."One DTP primary series dose was administered"
and Encounter."The latest DTP dose was administered more than 4 weeks ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="56"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Two DTP primary series doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Two DTP primary series doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "DTP-containing vaccines" and "Type of dose" = "Primary series") = 2
@code: Two DTP primary series doses were administered-123
@decision: IMMZ.D2.DT.DTP.On-time start: DTP vaccination schedule, on-time start (at ≤ 12 months of age)
@decision: IMMZ.D2.DT.DTP.Delayed or interrupted series: DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age
*/
define "Two DTP primary series doses were administered":
"Number of DTP Primary Series Doses Administered" = 2"/>
</extension>
<extension url="displaySequence">
<valueInteger value="57"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for DTP vaccination Case 3"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for DTP vaccination Case 3
@pseudocode: "Immunization recommendation status" = "Due" (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Client is due for DTP vaccination Case 3":
Encounter."Two DTP primary series doses were administered"
and Encounter."The latest DTP dose was administered more than 6 months ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="58"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for DTP vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for DTP vaccination
@pseudocode: "Immunization recommendation status" = "Due" (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Client is due for DTP vaccination":
"Client is due for DTP vaccination Case 1"
or "Client is due for DTP vaccination Case 2"
or "Client is due for DTP vaccination Case 3""/>
</extension>
<extension url="displaySequence">
<valueInteger value="59"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for DTP vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for DTP vaccination Guidance
@guidance = Should vaccinate client with first DTP dose as no DTP doses were administered and client's age is more than 1 year.
Check for contraindications.
@guidance = Should vaccinate client with second DTP dose as the latest DTP dose was administered more than 4 weeks ago.
Check for contraindications.
@guidance = Should vaccinate client with third DTP dose as the latest DTP dose was administered more than 6 months ago.
Check for contraindications.
*/
define "Client is due for DTP vaccination Guidance":
case
when "Client is due for DTP vaccination Case 1" then 'Should vaccinate client with first DTP dose as no DTP doses were administered and client\'s age is more than 1 year.
Check for contraindications.'
when "Client is due for DTP vaccination Case 2" then 'Should vaccinate client with second DTP dose as the latest DTP dose was administered more than 4 weeks ago.
Check for contraindications.'
when "Client is due for DTP vaccination Case 3" then 'Should vaccinate client with third DTP dose as the latest DTP dose was administered more than 6 months ago.
Check for contraindications.'
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="60"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for DTP vaccination Case 1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for DTP vaccination Case 1
@pseudocode: "Immunization recommendation status" = "Not due" (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Client is not due for DTP vaccination Case 1":
Encounter."One DTP primary series dose was administered"
and Encounter."The latest DTP dose was administered less than 4 weeks ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="61"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for DTP vaccination Case 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for DTP vaccination Case 2
@pseudocode: "Immunization recommendation status" = "Not due" (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Client is not due for DTP vaccination Case 2":
Encounter."Two DTP primary series doses were administered"
and Encounter."The latest DTP dose was administered less than 6 months ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="62"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for DTP vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for DTP vaccination
@pseudocode: "Immunization recommendation status" = "Not due" (where "Vaccine type" = "DTP-containing vaccines")
*/
define "Client is not due for DTP vaccination":
"Client is not due for DTP vaccination Case 1"
or "Client is not due for DTP vaccination Case 2""/>
</extension>
<extension url="displaySequence">
<valueInteger value="63"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for DTP vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for DTP vaccination Guidance
@guidance = Should not vaccinate client with second DTP dose as the latest DTP dose was administered less than 4 weeks ago.
Check for any other vaccines due and inform the caregiver of when to come back for second DTP dose
@guidance = Should not vaccinate client with third DTP dose the latest DTP dose was administered less than 6 months ago.
Check for any other vaccines due and inform the caregiver of when to come back for third DTP dose.
*/
define "Client is not due for DTP vaccination Guidance":
case
when "Client is not due for DTP vaccination Case 1" then 'Should not vaccinate client with second DTP dose as the latest DTP dose was administered less than 4 weeks ago.
Check for any other vaccines due and inform the caregiver of when to come back for second DTP dose'
when "Client is not due for DTP vaccination Case 2" then 'Should not vaccinate client with third DTP dose the latest DTP dose was administered less than 6 months ago.
Check for any other vaccines due and inform the caregiver of when to come back for third DTP dose.'
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="64"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dynamicValue: Guidance
*/
define "Guidance":
case
// Handling overlaps for Pertussis and Td boosters.
when "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose" and "Primary DTP series is complete. Client is not due for pertussis booster dose"
then "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose Guidance" + '\n' + "Primary DTP series is complete. Client is not due for pertussis booster dose Guidance"
when "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose" and "Primary DTP series is complete. Client is due for pertussis booster dose"
then "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose Guidance" + '\n' + "Primary DTP series is complete. Client is due for pertussis booster dose Guidance"
when "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose" and "Pertussis immunization schedule is complete"
then "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose Guidance" + '\n' + "Pertussis immunization schedule is complete Guidance"
when "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose" and "Primary DTP series is complete. Client is not due for pertussis booster dose"
then "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose Guidance" + '\n' + "Primary DTP series is complete. Client is not due for pertussis booster dose Guidance"
when "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose" and "Primary DTP series is complete. Client is due for pertussis booster dose"
then "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose Guidance" + '\n' + "Primary DTP series is complete. Client is due for pertussis booster dose Guidance"
when "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose" and "Pertussis immunization schedule is complete"
then "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose Guidance" + '\n' + "Pertussis immunization schedule is complete Guidance"
when "Client is not due for tetanus and diphtheria booster dose" and "Primary DTP series is complete. Client is not due for pertussis booster dose"
then "Client is not due for tetanus and diphtheria booster dose Guidance" + '\n' + "Primary DTP series is complete. Client is not due for pertussis booster dose Guidance"
when "Client is not due for tetanus and diphtheria booster dose" and "Primary DTP series is complete. Client is due for pertussis booster dose"
then "Client is not due for tetanus and diphtheria booster dose Guidance" + '\n' + "Primary DTP series is complete. Client is due for pertussis booster dose Guidance"
when "Client is not due for tetanus and diphtheria booster dose" and "Pertussis immunization schedule is complete"
then "Client is not due for tetanus and diphtheria booster dose Guidance" + '\n' + "Pertussis immunization schedule is complete Guidance"
when "Client is due for tetanus and diphtheria booster dose" and "Primary DTP series is complete. Client is not due for pertussis booster dose"
then "Client is due for tetanus and diphtheria booster dose Guidance" + '\n' + "Primary DTP series is complete. Client is not due for pertussis booster dose Guidance"
when "Client is due for tetanus and diphtheria booster dose" and "Primary DTP series is complete. Client is due for pertussis booster dose"
then "Client is due for tetanus and diphtheria booster dose Guidance" + '\n' + "Primary DTP series is complete. Client is due for pertussis booster dose Guidance"
when "Client is due for tetanus and diphtheria booster dose" and "Pertussis immunization schedule is complete"
then "Client is due for tetanus and diphtheria booster dose Guidance" + '\n' + "Pertussis immunization schedule is complete Guidance"
when "Tetanus and diphtheria immunization schedule is complete" and "Primary DTP series is complete. Client is not due for pertussis booster dose"
then "Tetanus and diphtheria immunization schedule is complete Guidance" + '\n' + "Primary DTP series is complete. Client is not due for pertussis booster dose Guidance"
when "Tetanus and diphtheria immunization schedule is complete" and "Primary DTP series is complete. Client is due for pertussis booster dose"
then "Tetanus and diphtheria immunization schedule is complete Guidance" + '\n' + "Primary DTP series is complete. Client is due for pertussis booster dose Guidance"
when "Tetanus and diphtheria immunization schedule is complete" and "Pertussis immunization schedule is complete"
then "Tetanus and diphtheria immunization schedule is complete Guidance" + '\n' + "Pertussis immunization schedule is complete Guidance"
when "Client is due for DTP vaccination" then "Client is due for DTP vaccination Guidance"
when "Client is not due for DTP vaccination" then "Client is not due for DTP vaccination Guidance"
when "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose" then "Primary DTP series is complete. Client is not due for tetanus and diphtheria booster dose Guidance"
when "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose" then "Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose Guidance"
when "Client is not due for tetanus and diphtheria booster dose" then "Client is not due for tetanus and diphtheria booster dose Guidance"
when "Client is due for tetanus and diphtheria booster dose" then "Client is due for tetanus and diphtheria booster dose Guidance"
when "Tetanus and diphtheria immunization schedule is complete" then "Tetanus and diphtheria immunization schedule is complete Guidance"
when "Primary DTP series is complete. Client is not due for pertussis booster dose" then "Primary DTP series is complete. Client is not due for pertussis booster dose Guidance"
when "Primary DTP series is complete. Client is due for pertussis booster dose" then "Primary DTP series is complete. Client is due for pertussis booster dose Guidance"
when "Pertussis immunization schedule is complete" then "Pertussis immunization schedule is complete Guidance"
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="65"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
</extension>
<extension url="name">
<valueString value="Has Guidance"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Guidance":
"Guidance" is not null and "Guidance" != ''"/>
</extension>
<extension url="displaySequence">
<valueInteger value="66"/>
</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="67"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZCommon"/>
</extension>
<extension url="name">
<valueString value="seriesPrimary"/>
</extension>
<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>
<extension url="displaySequence">
<valueInteger value="68"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value string): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="69"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value ImmunizationStatus): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="70"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToBoolean"/>
</extension>
<extension url="statement">
<valueString
value="define function ToBoolean(value boolean): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="71"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="72"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="73"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZCommon"/>
</extension>
<extension url="name">
<valueString value="seriesBooster"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @description: Gets the doses from the Booster series
*/
define fluent function seriesBooster(immunizations List<Immunization>):
immunizations I where
exists( I.protocolApplied pa where pa.series = 'Booster dose' )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="74"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="mostRecent"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function mostRecent(immunizations List<Immunization>):
Last(
immunizations I
sort by start of occurrence.toInterval()
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="75"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="FHIR model information"/>
<resource
value="http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Encounter"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZD2DTDTPEncounterElements"/>
</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
value="http://smart.who.int/immunizations/Library/WHOCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library DTPElements"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZD2DTDTPElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource
value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Elements"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource
value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
</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="Library WC"/>
<resource
value="http://smart.who.int/immunizations/Library/WHOCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Encounter"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZEncounterElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set DTP-containing vaccines"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE24"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Tetanus and diphtheria-containing vaccines"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE28"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Pertussis-containing vaccines"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE12"/>
</relatedArtifact>
<parameter>
<name value="Today"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="date"/>
</parameter>
<parameter>
<name value="Guidance"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Client is due for DTP vaccination"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name
value="Primary DTP series is complete. Client is due for pertussis booster dose"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name
value="Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Client is due for tetanus and diphtheria booster dose"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Has Guidance"/>
<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="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>
<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>
<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>
<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>
<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/IMMZD2DTDTPDelayedOrInterruptedSeries"/>
<version value="0.2.0"/>
<name value="IMMZD2DTDTPDelayedOrInterruptedSeries"/>
<title value="IMMZ.D2.DT.DTP.Delayed or interrupted series"/>
<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.D2.DT.DTP.Delayed or interrupted series
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age"/>
<relatedArtifact>
<type value="citation"/>
<citation
value="WHO recommendations for routine immunization - summary tables (January 2025)"/>
</relatedArtifact>
<library
value="http://smart.who.int/immunizations/Library/IMMZD2DTDTPDelayedOrInterruptedSeriesLogic"/>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="Delayed or interrupted DTP-containing series: for children whose vaccination series has been interrupted,
the series should be resumed without repeating previous doses. Children aged between 1 year and 7 years who have not
previously been vaccinated should receive 3 doses of vaccine following a 0, 1, 6-month schedule. Two subsequent booster
doses using tetanus toxoid with reduced diphtheria toxoid (Td) or Td with acellular pertussis (TdaP) combination vaccines
are needed with an interval of at least 1 year between doses. For those starting a tetanus and diphtheria-containing
vaccination series in adolescence or adulthood: from 7 years of age only Td combinations should be used. Age-appropriate
combinations-containing pertussis vaccine with reduced diphtheria toxoid are also available. If tetanus vaccination is
started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong
protection. Pregnant women and their newborn infants are protected from birth-associated tetanus if the mother received
either 6 tetanus-containing vaccine doses during childhood or 5 doses if first vaccinated during adolescence/adulthood
(documented by card, immunization registry and/or history) before the time of reproductive age. Vaccination history should
be verified in order to determine whether a dose of tetanus-containing vaccine is needed in the current pregnancy. In
countries where maternal and neonatal tetanus remains a public health problem, pregnant women for whom reliable information
on previous tetanus vaccinations is not available should receive at least 2 doses of tetanus-containing vaccines, preferably
Td, with an interval of at least 4 weeks between doses and the second dose at least 2 weeks before the birth. To ensure
protection for a minimum of 5 years, a third dose should be given at least 6 months later. A fourth and fifth dose should
be given at intervals of at least 1 year, or in subsequent pregnancies, in order to ensure lifelong protection. In
countries where maternal and neonatal tetanus is not a public health problem (low prevalence/high-income settings),
policy-makers may choose not to include tetanus vaccination among antenatal care interventions if effective tetanus
immunization programmes and good post-exposure prophylaxis exist outside of pregnancy. In countries where maternal
and neonatal tetanus is not a public health problem, the strategy may be to protect against tetanus via the infant
(3 DTP-containing vaccinations) and boosters programme. For more information, see the WHO guide Protecting all against
tetanus (5). For children aged under 7 years, diphtheria and tetanus toxoids and whole-cell pertussis (DTwP) or DTaP
combinations may be used. For children aged 4 years and older, Td-containing vaccine may be used and is preferred. For
children aged 7 years and older, only Td combinations should be used. Age-appropriate combinations-containing pertussis
vaccine with low-dose diphtheria antigen are also available. Only aP-containing vaccines should be used for vaccination
of persons aged 7 years and older."/>
</extension>
<title value="Determine if the client is due for DTP."/>
<description
value="Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age"/>
<condition>
<kind value="applicability"/>
<expression>
<description value="Client is due for DTP vaccination"/>
<language value="text/cql-identifier"/>
<expression value="Client is due for DTP vaccination"/>
</expression>
</condition>
<definitionCanonical
value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTMR"/>
<dynamicValue>
<path value="status"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'draft'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="intent"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'proposal'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="medication"/>
<expression>
<language value="text/cql-expression"/>
<expression
value="Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE24', display: 'DTP-containing vaccines' } }, display: 'DTP-containing vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="Delayed or interrupted DTP-containing series: for children whose vaccination series has been interrupted,
the series should be resumed without repeating previous doses. Children aged between 1 year and 7 years who have not
previously been vaccinated should receive 3 doses of vaccine following a 0, 1, 6-month schedule. Two subsequent booster
doses using tetanus toxoid with reduced diphtheria toxoid (Td) or Td with acellular pertussis (TdaP) combination vaccines
are needed with an interval of at least 1 year between doses. For those starting a tetanus and diphtheria-containing
vaccination series in adolescence or adulthood: from 7 years of age only Td combinations should be used. Age-appropriate
combinations-containing pertussis vaccine with reduced diphtheria toxoid are also available. If tetanus vaccination is
started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong
protection. Pregnant women and their newborn infants are protected from birth-associated tetanus if the mother received
either 6 tetanus-containing vaccine doses during childhood or 5 doses if first vaccinated during adolescence/adulthood
(documented by card, immunization registry and/or history) before the time of reproductive age. Vaccination history should
be verified in order to determine whether a dose of tetanus-containing vaccine is needed in the current pregnancy. In
countries where maternal and neonatal tetanus remains a public health problem, pregnant women for whom reliable information
on previous tetanus vaccinations is not available should receive at least 2 doses of tetanus-containing vaccines, preferably
Td, with an interval of at least 4 weeks between doses and the second dose at least 2 weeks before the birth. To ensure
protection for a minimum of 5 years, a third dose should be given at least 6 months later. A fourth and fifth dose should
be given at intervals of at least 1 year, or in subsequent pregnancies, in order to ensure lifelong protection. In
countries where maternal and neonatal tetanus is not a public health problem (low prevalence/high-income settings),
policy-makers may choose not to include tetanus vaccination among antenatal care interventions if effective tetanus
immunization programmes and good post-exposure prophylaxis exist outside of pregnancy. In countries where maternal
and neonatal tetanus is not a public health problem, the strategy may be to protect against tetanus via the infant
(3 DTP-containing vaccinations) and boosters programme. For more information, see the WHO guide Protecting all against
tetanus (5). For children aged under 7 years, diphtheria and tetanus toxoids and whole-cell pertussis (DTwP) or DTaP
combinations may be used. For children aged 4 years and older, Td-containing vaccine may be used and is preferred. For
children aged 7 years and older, only Td combinations should be used. Age-appropriate combinations-containing pertussis
vaccine with low-dose diphtheria antigen are also available. Only aP-containing vaccines should be used for vaccination
of persons aged 7 years and older."/>
</extension>
<title value="Determine if the client is due for DTP."/>
<description
value="Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age"/>
<condition>
<kind value="applicability"/>
<expression>
<description
value="Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose"/>
<language value="text/cql-identifier"/>
<expression
value="Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose"/>
</expression>
</condition>
<definitionCanonical
value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTMR"/>
<dynamicValue>
<path value="status"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'draft'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="intent"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'proposal'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="medication"/>
<expression>
<language value="text/cql-expression"/>
<expression
value="Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE28', display: 'Tetanus and diphtheria-containing vaccines' } }, display: 'Tetanus and diphtheria-containing vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="Delayed or interrupted DTP-containing series: for children whose vaccination series has been interrupted,
the series should be resumed without repeating previous doses. Children aged between 1 year and 7 years who have not
previously been vaccinated should receive 3 doses of vaccine following a 0, 1, 6-month schedule. Two subsequent booster
doses using tetanus toxoid with reduced diphtheria toxoid (Td) or Td with acellular pertussis (TdaP) combination vaccines
are needed with an interval of at least 1 year between doses. For those starting a tetanus and diphtheria-containing
vaccination series in adolescence or adulthood: from 7 years of age only Td combinations should be used. Age-appropriate
combinations-containing pertussis vaccine with reduced diphtheria toxoid are also available. If tetanus vaccination is
started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong
protection. Pregnant women and their newborn infants are protected from birth-associated tetanus if the mother received
either 6 tetanus-containing vaccine doses during childhood or 5 doses if first vaccinated during adolescence/adulthood
(documented by card, immunization registry and/or history) before the time of reproductive age. Vaccination history should
be verified in order to determine whether a dose of tetanus-containing vaccine is needed in the current pregnancy. In
countries where maternal and neonatal tetanus remains a public health problem, pregnant women for whom reliable information
on previous tetanus vaccinations is not available should receive at least 2 doses of tetanus-containing vaccines, preferably
Td, with an interval of at least 4 weeks between doses and the second dose at least 2 weeks before the birth. To ensure
protection for a minimum of 5 years, a third dose should be given at least 6 months later. A fourth and fifth dose should
be given at intervals of at least 1 year, or in subsequent pregnancies, in order to ensure lifelong protection. In
countries where maternal and neonatal tetanus is not a public health problem (low prevalence/high-income settings),
policy-makers may choose not to include tetanus vaccination among antenatal care interventions if effective tetanus
immunization programmes and good post-exposure prophylaxis exist outside of pregnancy. In countries where maternal
and neonatal tetanus is not a public health problem, the strategy may be to protect against tetanus via the infant
(3 DTP-containing vaccinations) and boosters programme. For more information, see the WHO guide Protecting all against
tetanus (5). For children aged under 7 years, diphtheria and tetanus toxoids and whole-cell pertussis (DTwP) or DTaP
combinations may be used. For children aged 4 years and older, Td-containing vaccine may be used and is preferred. For
children aged 7 years and older, only Td combinations should be used. Age-appropriate combinations-containing pertussis
vaccine with low-dose diphtheria antigen are also available. Only aP-containing vaccines should be used for vaccination
of persons aged 7 years and older."/>
</extension>
<title value="Determine if the client is due for DTP."/>
<description
value="Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age"/>
<condition>
<kind value="applicability"/>
<expression>
<description
value="Client is due for tetanus and diphtheria booster dose"/>
<language value="text/cql-identifier"/>
<expression
value="Client is due for tetanus and diphtheria booster dose"/>
</expression>
</condition>
<definitionCanonical
value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTMR"/>
<dynamicValue>
<path value="status"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'draft'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="intent"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'proposal'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="medication"/>
<expression>
<language value="text/cql-expression"/>
<expression
value="Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE28', display: 'Tetanus and diphtheria-containing vaccines' } }, display: 'Tetanus and diphtheria-containing vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="The duration of protection following primary immunization varies considerably
depending upon factors such as local epidemiology, vaccination schedule and choice of vaccine. Therefore, a booster
dose is recommended for children aged 1–6 years, preferably during the second year of life (≥ 6 months after last
primary dose), unless otherwise indicated by local epidemiology; the contact could also be used to catch up on any
missed doses of other vaccines. This schedule should provide protection for at least 6 years for countries using
wP-containing vaccine. For countries using aP-containing vaccine, protection may decline appreciably before 6 years
of age. Only aP-containing vaccines should be used for vaccination of persons aged 7 years and older. Although a
booster dose in adolescence was shown to decrease disease in adolescents, this is not generally recommended as a
means of controlling pertussis in infants. A decision to introduce adolescent and/or adult boosters should only
be taken after careful assessment of local epidemiology, estimation of the contribution of adolescents as source
of infections of young infants, and selection of adolescents and/or adults as target groups for vaccination. Decisions
concerning such programmes should be based on the incidence and cost–effectiveness data. High coverage of routine
immunization in infants must be in place prior to the introduction of vaccination of adolescents and adults. "/>
</extension>
<title value="Determine if the client is due for DTP."/>
<description
value="Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age"/>
<condition>
<kind value="applicability"/>
<expression>
<description
value="Primary DTP series is complete. Client is due for pertussis booster dose"/>
<language value="text/cql-identifier"/>
<expression
value="Primary DTP series is complete. Client is due for pertussis booster dose"/>
</expression>
</condition>
<definitionCanonical
value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTMR"/>
<dynamicValue>
<path value="status"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'draft'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="intent"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'proposal'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="medication"/>
<expression>
<language value="text/cql-expression"/>
<expression
value="Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE12', display: 'Pertussis-containing vaccines' } }, display: 'Pertussis-containing vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<title
value="Check for Guidance for the patient regarding IMMZ.D2.DT.DTP.Delayed or interrupted series."/>
<description
value="Show Guidance for the patient regarding IMMZ.D2.DT.DTP.Delayed or interrupted series."/>
<condition>
<kind value="applicability"/>
<expression>
<description value="Has Guidance"/>
<language value="text/cql-identifier"/>
<expression value="Has Guidance"/>
</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="Guidance"/>
</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>