http://smart.who.int/immunizations/PlanDefinition/IMMZD2DTDengue3DosesWithoutPreVaccinationScreening
type: PlanDefinition
node role: treeRoot
meta:
  profile:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition
    l: cpg-recommendationdefinition
  profile:
    v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareableplandefinition
    l: crmi-shareableplandefinition
  profile:
    v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishableplandefinition
    l: crmi-publishableplandefinition
text:
  status:
    v: extensions
  div:
    v: Id: IMMZD2DTDengue3DosesWithoutPreVaccinationScreening Url: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening Version: 0.2.0 Title: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening Status: draft Type: system: http://terminology.hl7.org/CodeSystem/plan-definition-type code: eca-rule Date: 2026-03-03 13:07:11+0000 Publisher: WHO Description: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic Actions: Determine if the client is due for Dengue.: Determine if the client is due for Dengue vaccine according to the national immunization protocol. CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] If: Applicability: Client is due for dengue vaccination (Client is due for dengue vaccination) Then: Definition: IMMZD2DTMR Dynamic Values: status: ('draft') intent: ('proposal') medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE25', display: 'Dengue vaccines' } }, display: 'Dengue vaccines' }) Check for Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening.: Show Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening. If: Applicability: Has Guidance (Has Guidance) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Guidance) category.coding: (Code { system: 'http://terminology.hl7.org/CodeSystem/comm…
contained: Library
  id:
    v: effective-data-requirements
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: IMMZEncounterElements
    extension:
      url:
        v: name
        l: name
      value: String
        v: Current Patient Age In Years
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: /** * @dataElement Patient age in years */ define "Current Patient Age In Years": AgeInYearsAt(Today)
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 0
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: IMMZD2DTDengueEncounterElements
    extension:
      url:
        v: name
        l: name
      value: String
        v: Client's age is less than 9 years
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: /* @input: Client's age is less than 9 years @pseudocode: Today's date − "Date of birth" < 9 years @code: Client's age is less than 9 years-40 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "Client's age is less than 9 years": Encounter."Current Patient Age In Years" < 9
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 1
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
    extension:
      url:
        v: name
        l: name
      value: String
        v: Client is not due for dengue vaccination Case 1
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: /* @output: Client is not due for dengue vaccination Case 1 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination Case 1": Encounter."Client's age is less than 9 years"
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 2
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: IMMZD2DTDengueEncounterElements
    extension:
      url:
        v: name
        l: name
      value: String
        v: Client's age is more than 45 years
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: /* @input: Client's age is more than 45 years @pseudocode: Today's date − "Date of birth" > 45 years @code: Client's age is more than 45 years-41 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "Client's age is more than 45 years": Encounter."Current Patient Age In Years" > 45
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 3
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
    extension:
      url:
        v: name
        l: name
      value: String
        v: Client is not due for dengue vaccination Case 2
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: /* @output: Client is not due for dengue vaccination Case 2 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination Case 2": Encounter."Client's age is more than 45 years"
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 4
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: IMMZElements
    extension:
      url:
        v: name
        l: name
      value: String
        v: Doses Administered to Patient
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: /** * @dataElement All Doses Administered to Patient */ define "Doses Administered to Patient": [Immunization] I where I.status = 'completed' and I.isSubpotent is not true
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 5
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: IMMZEncounterElements
    extension:
      url:
        v: name
        l: name
      value: String
        v: Doses Administered to Patient
    extension:
      url:
        v: statement
        l: statement
      value: String

String
v: /** * @dataElement All Doses Administered to Patient */ define "Doses Administered to Patient": Elements."Doses Administered to Patient" I where I.occurrence.toInterval() same day or before Today

url:
  v: displaySequence
  l: displaySequence
value: Integer
  v: 6

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: Dengue Doses Administered to Patient
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @internal: Dengue containing Doses Administered to Patient */ define "Dengue Doses Administered to Patient": Encounter."Doses Administered to Patient" I where I.vaccineCode in Concepts."Dengue vaccines"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: Dengue Primary Series Doses Administered to Patient
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @internal: Dengue containing Doses Administered to Patient that are in the Primary series */ define "Dengue Primary Series Doses Administered to Patient": "Dengue Doses Administered to Patient".seriesPrimary()
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: Number of Dengue Primary Series Doses Administered
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @internal: Number of Dengue Primary Series doses */ define "Number of Dengue Primary Series Doses Administered": Count("Dengue Primary Series Doses Administered to Patient")
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: One dengue primary series dose was administered
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @input: One dengue primary series dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 1 @code: One dengue primary series dose was administered-115 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "One dengue primary series dose was administered": "Number of Dengue Primary Series Doses Administered" = 1
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: Client's age is between 9 years and 45 years
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @input: Client's age is between 9 years and 45 years @pseudocode: 9 years ≤ Today's date − "Date of birth" ≤ 45 years @code: Client's age is between 9 years and 45 years-51 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "Client's age is between 9 years and 45 years": Encounter."Current Patient Age In Years" >= 9 and Encounter."Current Patient Age In Years" <= 45
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: Date of Latest Dengue Dose
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @internal: Date of Latest Dengue Dose */ define "Date of Latest Dengue Dose": date from start of "Dengue Doses Administered to Patient".mostRecent().occurrence.toInterval()
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 12
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: The latest dengue dose was administered less than 6 months ago
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @input: The latest dengue dose was administered less than 6 months ago @pseudocode: Today's date - Latest "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") < 6 months @code: The latest dengue dose was administered less than 6 months ago-106 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "The latest dengue dose was administered less than 6 months ago": "Date of Latest Dengue Dose" is not null and duration in months between "Date of Latest Dengue Dose" and Today < 6
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Client is not due for dengue vaccination Case 3
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Client is not due for dengue vaccination Case 3 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination Case 3": Encounter."One dengue primary series dose was administered" and Encounter."Client's age is between 9 years and 45 years" and Encounter."The latest dengue dose was administered less than 6 months ago"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: Two dengue primary series doses were administered
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @input: Two dengue primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 2 @code: Two dengue primary series doses were administered-115 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "Two dengue primary series doses were administered": "Number of Dengue Primary Series Doses Administered" = 2
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Client is not due for dengue vaccination Case 4
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Client is not due for dengue vaccination Case 4 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination Case 4": Encounter."Two dengue primary series doses were administered" and Encounter."Client's age is between 9 years and 45 years" and Encounter."The latest dengue dose was administered less than 6 months ago"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 16
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Client is not due for dengue vaccination
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Client is not due for dengue vaccination @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination": "Client is not due for dengue vaccination Case 1" or "Client is not due for dengue vaccination Case 2" or "Client is not due for dengue vaccination Case 3" or "Client is not due for dengue vaccination Case 4"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 17
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Client is not due for dengue vaccination Guidance
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Client is not due for dengue vaccination Guidance @guidance = Should not vaccinate client with first dengue dose as client's age is less than 9 years. Check for any other vaccines due and inform the caregiver of when to come back for first dose. @guidance = Should not vaccinate client with first dengue dose as client's age is more than 45 years. Check for any vaccines due. @guidance = Should not vaccinate client with second dengue dose as latest dengue dose was administered less than 6 months ago. Check for any other vaccines due and inform the caregiver of when to come back for the second dose. @guidance = Should not vaccinate client with third dengue dose as latest dengue vaccine was administered less than 6 months ago. Check for any other vaccines due and inform the caregiver of when to come back for the third dose. */ define "Client is not due for dengue vaccination Guidance": case when "Client is not due for dengue vaccination Case 1" then 'Should not vaccinate client with first dengue dose as client\'s age is less than 9 years. Check for any other vaccines due and inform the caregiver of when to come back for first dose.' when "Client is not due for dengue vaccination Case 2" then 'Should not vaccinate client with first dengue dose as client\'s age is more than 45 years. Check for any vaccines due.' when "Client is not due for dengue vaccination Case 3" then 'Should not vaccinate client with second dengue dose as latest dengue dose was administered less than 6 months ago. Check for any other vaccines due and inform the caregiver of when to come back for the second dose.' when "Client is not due for dengue vaccination Case 4" then 'Should not vaccinate client with third dengue dose as latest dengue vaccine was administered less than 6 months ago. Check for any other vaccines due and inform the caregiver of when to come back for the third dose.' else '' end
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 18
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: No dengue primary series doses were administered
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @input: No dengue primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 0 @code: No dengue primary series doses were administered-115 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "No dengue primary series doses were administered": "Number of Dengue Primary Series Doses Administered" = 0
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 19
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Client is due for dengue vaccination Case 1
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Client is due for dengue vaccination Case 1 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for dengue vaccination Case 1": Encounter."No dengue primary series doses were administered" and Encounter."Client's age is between 9 years and 45 years"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 20
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: The latest dengue dose was administered more than 6 months ago
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @input: The latest dengue dose was administered more than 6 months ago @pseudocode: Today's date - Latest "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") ≥ 6 months @code: The latest dengue dose was administered more than 6 months ago-106 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "The latest dengue dose was administered more than 6 months ago": "Date of Latest Dengue Dose" is not null and duration in months between "Date of Latest Dengue Dose" and Today >= 6
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 21
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Client is due for dengue vaccination Case 2
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Client is due for dengue vaccination Case 2 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for dengue vaccination Case 2": Encounter."One dengue primary series dose was administered" and Encounter."Client's age is between 9 years and 45 years" and Encounter."The latest dengue dose was administered more than 6 months ago"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 22
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Client is due for dengue vaccination Case 3
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Client is due for dengue vaccination Case 3 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for dengue vaccination Case 3": Encounter."Two dengue primary series doses were administered" and Encounter."Client's age is between 9 years and 45 years" and Encounter."The latest dengue dose was administered more than 6 months ago"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 23
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Client is due for dengue vaccination
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Client is due for dengue vaccination @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for dengue vaccination": "Client is due for dengue vaccination Case 1" or "Client is due for dengue vaccination Case 2" or "Client is due for dengue vaccination Case 3"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 24
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Client is due for dengue vaccination Guidance
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Client is due for dengue vaccination Guidance @guidance = Should vaccinate client with first dengue dose as no dengue doses were administered and client is within appropriate age range. Check for contraindications. @guidance = Should vaccinate client with second dengue dose as latest dengue dose was administered more than 6 months ago. Check for contraindications. @guidance = Should vaccinate client with third dengue dose as latest dengue dose was administered more than 6 months ago. Check for contraindications. */ define "Client is due for dengue vaccination Guidance": case when "Client is due for dengue vaccination Case 1" then 'Should vaccinate client with first dengue dose as no dengue doses were administered and client is within appropriate age range. Check for contraindications.' when "Client is due for dengue vaccination Case 2" then 'Should vaccinate client with second dengue dose as latest dengue dose was administered more than 6 months ago. Check for contraindications.' when "Client is due for dengue vaccination Case 3" then 'Should vaccinate client with third dengue dose as latest dengue dose was administered more than 6 months ago. Check for contraindications.' else '' end
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 25
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZD2DTDengueEncounterElements
extension:
  url:
    v: name
    l: name
  value: String
    v: Three dengue primary series doses were administered
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @input: Three dengue primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 3 @code: Three dengue primary series doses were administered-115 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "Three dengue primary series doses were administered": "Number of Dengue Primary Series Doses Administered" = 3
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 26
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Dengue immunization schedule is complete
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Dengue immunization schedule is complete @pseudocode: "Immunization recommendation status" = "Complete" "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Dengue vaccines")" */ define "Dengue immunization schedule is complete": Encounter."Three dengue primary series doses were administered" and Encounter."Client's age is between 9 years and 45 years"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 27
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Dengue immunization schedule is complete Guidance
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @output: Dengue immunization schedule is complete Guidance @guidance: Dengue immunization schedule is complete. Three dengue primary series doses were administered. Check for any other vaccines due. */ define "Dengue immunization schedule is complete Guidance": 'Dengue immunization schedule is complete. Three dengue primary series doses were administered. Check for any other vaccines due.'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 28
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Guidance
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @dynamicValue: Guidance */ define "Guidance": case when "Client is not due for dengue vaccination" then "Client is not due for dengue vaccination Guidance" when "Client is due for dengue vaccination" then "Client is due for dengue vaccination Guidance" when "Dengue immunization schedule is complete" then "Dengue immunization schedule is complete Guidance" else '' end
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 29
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Guidance
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Guidance": "Guidance" is not null and "Guidance" != ''
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 30
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: IMMZCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: seriesPrimary
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /** * @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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 31
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value string): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 32
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value ImmunizationStatus): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 33
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToBoolean
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToBoolean(value boolean): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 34
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToConcept
extension:
  url:
    v: statement
    l: statement
  value: String
    v: 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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 35
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToCode
extension:
  url:
    v: statement
    l: statement
  value: String
    v: 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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 36
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: WHOCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: mostRecent
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define fluent function mostRecent(immunizations List<Immunization>): Last( immunizations I sort by start of occurrence.toInterval() )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 37
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

v: EffectiveDataRequirements

v: active

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/library-type
    l: library-type
  code:
    v: module-definition

type:
  v: depends-on
display:
  v: FHIR model information
resource:
  v: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
  l: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo

type:
  v: depends-on
display:
  v: Library Encounter
resource:
  v: http://smart.who.int/immunizations/Library/IMMZD2DTDengueEncounterElements
  l: IMMZD2DTDengueEncounterElements

type:
  v: depends-on
display:
  v: Library Encounter
resource:
  v: http://smart.who.int/immunizations/Library/IMMZEncounterElements
  l: IMMZEncounterElements

type:
  v: depends-on
display:
  v: Library Common
resource:
  v: http://smart.who.int/immunizations/Library/IMMZCommon
  l: IMMZCommon

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
  l: http://fhir.org/guides/cqf/common/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library Elements
resource:
  v: http://smart.who.int/immunizations/Library/IMMZElements
  l: IMMZElements

type:
  v: depends-on
display:
  v: Library WC
resource:
  v: http://smart.who.int/immunizations/Library/WHOCommon
  l: WHOCommon

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
  l: http://fhir.org/guides/cqf/common/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library Concepts
resource:
  v: http://smart.who.int/immunizations/Library/IMMZConcepts
  l: IMMZConcepts

type:
  v: depends-on
display:
  v: Library WC
resource:
  v: http://smart.who.int/immunizations/Library/WHOCommon
  l: WHOCommon

type:
  v: depends-on
display:
  v: Value set Dengue vaccines
resource:
  v: http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE25
  l: IMMZ.Z.DE25

name:
  v: Today
use:
  v: in
min:
  v: 0
max:
  v: 1
type:
  v: date

name:
  v: Guidance
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: string

name:
  v: Has Guidance
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: Client is due for dengue vaccination
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/StructureDefinition/Patient
  l: Patient

type:
  v: Immunization
profile:
  v: http://hl7.org/fhir/StructureDefinition/Immunization
  l: Immunization
must support:
  v: status
must support:
  v: isSubpotent

type:
  v: Immunization
profile:
  v: http://hl7.org/fhir/StructureDefinition/Immunization
  l: Immunization
must support:
  v: status
must support:
  v: isSubpotent
must support:
  v: occurrence

type:
  v: Immunization
profile:
  v: http://hl7.org/fhir/StructureDefinition/Immunization
  l: Immunization
must support:
  v: status
must support:
  v: isSubpotent
must support:
  v: occurrence
must support:
  v: vaccineCode

type:
  v: Immunization
profile:
  v: http://hl7.org/fhir/StructureDefinition/Immunization
  l: Immunization
must support:
  v: status
must support:
  v: isSubpotent
must support:
  v: occurrence
must support:
  v: vaccineCode

type:
  v: Immunization
profile:
  v: http://hl7.org/fhir/StructureDefinition/Immunization
  l: Immunization
must support:
  v: status
must support:
  v: isSubpotent
must support:
  v: occurrence
must support:
  v: vaccineCode

url:
  v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  l: cpg-knowledgeCapability
value: Code
  v: computable

url:
  v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
  l: crmi-effectiveDataRequirements
value: Canonical
  v: #effective-data-requirements
  l: effective-data-requirements

v: 0.2.0

v: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/plan-definition-type
    l: plan-definition-type
  code:
    v: eca-rule

v: draft

v: false

v: 2026-03-03T13:07:11+00:00

v: WHO

name:
  v: WHO
telecom:
  system:
    v: url
  value:
    v: http://who.int

v: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years]

type:
  v: citation
citation:
  v: WHO recommendations for routine immunization - summary tables (January 2025)

extension:
  url:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
    l: cpg-rationale
  value: Markdown
    v: Currently, the dengue vaccine should be used within the indicated age range, which in most countries is 9–45 years. If pre-vaccination screening is not feasible, vaccination without individual screening could be considered in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years. Communication needs to ensure appropriate and full disclosure of the risks of vaccination of persons with unknown serostatus. CYD-TDV is recommended as a 3-dose series given 6 months apart. Should a vaccine dose be delayed for any reason, it is not necessary to restart the course and the next dose in the series should be administered as soon as possible.
title:
  v: Determine if the client is due for Dengue.
description:
  v: Determine if the client is due for Dengue vaccine according to the national immunization protocol. CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years]
condition:
  kind:
    v: applicability
  expression:
    description:
      v: Client is due for dengue vaccination
    language:
      v: text/cql-identifier
    expression:
      v: Client is due for dengue vaccination
definition: Canonical
  v: http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTMR
  l: IMMZD2DTMR
dynamic value:
  path:
    v: status
  expression:
    language:
      v: text/cql-expression
    expression:
      v: 'draft'
dynamic value:
  path:
    v: intent
  expression:
    language:
      v: text/cql-expression
    expression:
      v: 'proposal'
dynamic value:
  path:
    v: medication
  expression:
    language:
      v: text/cql-expression
    expression:
      v: Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE25', display: 'Dengue vaccines' } }, display: 'Dengue vaccines' }

title:
  v: Check for Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening.
description:
  v: Show Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening.
condition:
  kind:
    v: applicability
  expression:
    description:
      v: Has Guidance
    language:
      v: text/cql-identifier
    expression:
      v: Has Guidance
definition: Canonical
  v: http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTCR
  l: IMMZD2DTCR
dynamic value:
  path:
    v: status
  expression:
    language:
      v: text/cql-expression
    expression:
      v: 'active'
dynamic value:
  path:
    v: payload.contentString
  expression:
    language:
      v: text/cql-identifier
    expression:
      v: Guidance
dynamic value:
  path:
    v: category.coding
  expression:
    description:
      v: Category of communication
    language:
      v: text/cql-expression
    expression:
      v: Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
dynamic value:
  path:
    v: priority
  expression:
    description:
      v: Alert priority
    language:
      v: text/cql-expression
    expression:
      v: Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }