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="IMMZD2DTHepatitisBDelayedStart"/>
<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;">IMMZD2DTHepatitisBDelayedStart</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD2DTHepatitisBDelayedStart.html">IMMZ.D2.DT.Hepatitis B.Delayed start</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.Hepatitis B.Delayed start</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.Hepatitis B.Delayed start
3-dose schedule (no birth dose + 3 doses), delayed start</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-IMMZD2DTHepatitisBDelayedStartLogic.html">IMMZD2DTHepatitisBDelayedStartLogic</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 a hepatitis B vaccination according to the national immunization schedule:</b> Determine if the client is due for a hepatitis B vaccination according to the national immunization schedule
3-dose schedule (no birth dose + 3 doses), delayed start
<br/>
<b>If:</b>
<i>Applicability:</i>
Client is due for hepatitis B vaccination
<i>(Client is due for hepatitis B 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: 'DE6', display: 'Hepatitis B-containing vaccines' } }, display: 'Hepatitis B-containing vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Determine if the client is due for a hepatitis B vaccination according to the national immunization schedule:</b> Determine if the client is due for a hepatitis B vaccination according to the national immunization schedule
3-dose schedule (no birth dose + 3 doses), delayed start
<br/>
<b>If:</b>
<i>Applicability:</i>
Client is due for a hepatitis B vaccination
<i>(Client is due for a hepatitis B 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: 'DE6', display: 'Hepatitis B-containing vaccines' } }, display: 'Hepatitis B-containing vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Check for Guidance for the patient regarding IMMZ.D2.DT.Hepatitis B.Delayed start.:</b> Show Guidance for the patient regarding IMMZ.D2.DT.Hepatitis B.Delayed start.
<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>
</div>
</text>
<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="IMMZD2DTHepatitisBElements"/>
</extension>
<extension url="name">
<valueString value="Hepatitis B Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Hepatitis B containing Doses Administered to Patient
*/
define "Hepatitis B Doses Administered to Patient":
Elements."Doses Administered to Patient" I
where
I.vaccineCode in Concepts."Hepatitis B-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="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Hepatitis B Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Hepatitis B containing Doses Administered to Patient
*/
define "Hepatitis B Doses Administered to Patient":
HepatitisBElements."Hepatitis B Doses Administered to Patient".onOrBefore(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Number of Hepatitis B Doses Administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Number of Hepatitis B Doses Administered
*/
define "Number of Hepatitis B Doses Administered":
Count("Hepatitis B Doses Administered to Patient")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString value="No hepatitis B doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No hepatitis B doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines") = 0
@code: No hepatitis B doses were administered-93
@decision: IMMZ.D2.DT.Hepatitis B.Delayed start: 3-dose schedule (no birth dose + 3 doses), delayed start
*/
define "No hepatitis B doses were administered":
"Number of Hepatitis B Doses Administered" = 0"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</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 Days"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @dataElement Patient age in days
*/
define "Current Patient Age In Days":
AgeInDaysAt(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Client's age is more than {Member States defined lower limit}"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is more than {Member States defined lower limit}
@pseudocode: Today's date − "Date of birth" > Member States defined lower limit
@code: Client's age is more than {Member States defined lower limit}-66
@decision: IMMZ.D2.DT.Hepatitis B.Delayed start: 3-dose schedule (no birth dose + 3 doses), delayed start
*/
define "Client's age is more than {Member States defined lower limit}":
Encounter."Current Patient Age In Days" >= HepBBirthDoseAgeLimitDays"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for hepatitis B vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for hepatitis B vaccination
@pseudocode: "Immunization recommendation status" = "Due"
*/
define "Client is due for hepatitis B vaccination":
Encounter."No hepatitis B doses were administered"
and Encounter."Client's age is more than {Member States defined lower limit}""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is due for hepatitis B vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for hepatitis B vaccination Guidance
@guidance: Should vaccinate client with first hepatitis B dose as hepatitis B birth dose was not administered. The first hepatitis B dose should be administered as soon as possible.
Check for contraindications.
*/
define "Client is due for hepatitis B vaccination Guidance":
'Should vaccinate client with first hepatitis B dose as hepatitis B birth dose was not administered. The first hepatitis B dose should be administered as soon as possible.
Check for contraindications.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString value="One hepatitis B dose was administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: One hepatitis B dose was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines") = 1
@code: One hepatitis B dose was administered-93
@decision: IMMZ.D2.DT.Hepatitis B.Delayed start: 3-dose schedule (no birth dose + 3 doses), delayed start
*/
define "One hepatitis B dose was administered":
"Number of Hepatitis B Doses Administered" = 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Date of Latest Hepatitis B Dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Date of Latest Hepatitis B Dose
*/
define "Date of Latest Hepatitis B Dose":
date from start of "Hepatitis B Doses Administered to Patient".mostRecent().occurrence.toInterval()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest hepatitis B dose was administered less than 4 weeks ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest hepatitis B dose was administered less than 4 weeks ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") < 4 weeks
@code: The latest hepatitis B dose was administered less than 4 weeks ago-121
@decision: IMMZ.D2.DT.Hepatitis B.3 doses: 3-dose schedule (birth dose + 2 primary series doses), on-time start
@decision: IMMZ.D2.DT.Hepatitis B.4 doses: 4-dose schedule (birth dose + 3 primary series doses), on-time start
@decision: IMMZ.D2.DT.Hepatitis B.Delayed start: 3-dose schedule (no birth dose + 3 doses), delayed start
*/
define "The latest hepatitis B dose was administered less than 4 weeks ago":
"Date of Latest Hepatitis B Dose" is not null
and duration in weeks between "Date of Latest Hepatitis B Dose" and Today < 4"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for a hepatitis B vaccination Case 1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for a hepatitis B vaccination Case 1
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for a hepatitis B vaccination Case 1":
Encounter."One hepatitis B dose was administered"
and Encounter."The latest hepatitis B dose was administered less than 4 weeks ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Two hepatitis B doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Two hepatitis B doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines") = 2
@code: Two hepatitis B doses were administered-93
@decision: IMMZ.D2.DT.Hepatitis B.Delayed start: 3-dose schedule (no birth dose + 3 doses), delayed start
*/
define "Two hepatitis B doses were administered":
"Number of Hepatitis B Doses Administered" = 2"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for a hepatitis B vaccination Case 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for a hepatitis B vaccination Case 2
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for a hepatitis B vaccination Case 2":
Encounter."Two hepatitis B doses were administered"
and Encounter."The latest hepatitis B dose was administered less than 4 weeks ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest hepatitis B dose was administered more than 4 weeks ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest hepatitis B dose was administered more than 4 weeks ago
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") ≥ 4 weeks
@code: The latest hepatitis B dose was administered more than 4 weeks ago-121
@decision: IMMZ.D2.DT.Hepatitis B.3 doses: 3-dose schedule (birth dose + 2 primary series doses), on-time start
@decision: IMMZ.D2.DT.Hepatitis B.4 doses: 4-dose schedule (birth dose + 3 primary series doses), on-time start
@decision: IMMZ.D2.DT.Hepatitis B.Delayed start: 3-dose schedule (no birth dose + 3 doses), delayed start
*/
define "The latest hepatitis B dose was administered more than 4 weeks ago":
not("The latest hepatitis B dose was administered less than 4 weeks ago")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Date of First Hepatitis B Dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Date of First Hepatitis B Dose
*/
define "Date of First Hepatitis B Dose":
date from start of "Hepatitis B Doses Administered to Patient".earliest().occurrence.toInterval()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The first hepatitis B dose was administered less than 6 months ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The first hepatitis B dose was administered less than 6 months ago
@pseudocode: Today's date − "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Dose number" = 1) < 6 months
@code: The first hepatitis B dose was administered less than 6 months ago-137
@decision: IMMZ.D2.DT.Hepatitis B.Delayed start: 3-dose schedule (no birth dose + 3 doses), delayed start
*/
define "The first hepatitis B dose was administered less than 6 months ago":
"Date of First Hepatitis B Dose" is not null
and duration in months between "Date of First Hepatitis B Dose" and Today < 6"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for a hepatitis B vaccination Case 3"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for a hepatitis B vaccination Case 3
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for a hepatitis B vaccination Case 3":
Encounter."Two hepatitis B doses were administered"
and Encounter."The latest hepatitis B dose was administered more than 4 weeks ago"
and Encounter."The first hepatitis B dose was administered less than 6 months ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for a hepatitis B vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for a hepatitis B vaccination
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for a hepatitis B vaccination":
"Client is not due for a hepatitis B vaccination Case 1"
or "Client is not due for a hepatitis B vaccination Case 2"
or "Client is not due for a hepatitis B vaccination Case 3""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for a hepatitis B vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for a hepatitis B vaccination Guidance
@guidance = Should not vaccinate client with second hepatitis B dose as the latest hepatitis B dose was administered less than 4 weeks ago.
Check for any other vaccines due, and inform the caregiver of when to come back for the next dose.
@guidance = Should not vaccinate client with second hepatitis B dose as the latest hepatitis B dose was administered less than 4 weeks ago. Two hepatitis B doses have been administered to the client.
Check for any other vaccines due, and inform the caregiver of when to come back for the next dose.
@guidance = Should not vaccinate client with third hepatitis B dose as the first hepatitis B 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 next dose.
*/
define "Client is not due for a hepatitis B vaccination Guidance":
case
when "Client is not due for a hepatitis B vaccination Case 1" then 'Should not vaccinate client with second hepatitis B dose as the latest hepatitis B dose was administered less than 4 weeks ago.
Check for any other vaccines due, and inform the caregiver of when to come back for the next dose.'
when "Client is not due for a hepatitis B vaccination Case 2" then 'Should not vaccinate client with second hepatitis B dose as the latest hepatitis B dose was administered less than 4 weeks ago. Two hepatitis B doses have been administered to the client.
Check for any other vaccines due, and inform the caregiver of when to come back for the next dose.'
when "Client is not due for a hepatitis B vaccination Case 3" then 'Should not vaccinate client with third hepatitis B dose as the first hepatitis B 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 next dose.'
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is due for a hepatitis B vaccination Case 1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for a hepatitis B vaccination Case 1
@pseudocode: "Immunization recommendation status" = "Due"
*/
define "Client is due for a hepatitis B vaccination Case 1":
Encounter."One hepatitis B dose was administered"
and Encounter."The latest hepatitis B dose was administered more than 4 weeks ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The first hepatitis B dose was administered more than 6 months ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The first hepatitis B dose was administered more than 6 months ago
@pseudocode: Today's date − "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Dose number" = 1) ≥ 6 months
@code: The first hepatitis B dose was administered more than 6 months ago-137
@decision: IMMZ.D2.DT.Hepatitis B.Delayed start: 3-dose schedule (no birth dose + 3 doses), delayed start
*/
define "The first hepatitis B dose was administered more than 6 months ago":
not("The first hepatitis B dose was administered less than 6 months ago")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is due for a hepatitis B vaccination Case 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for a hepatitis B vaccination Case 2
@pseudocode: "Immunization recommendation status" = "Due"
*/
define "Client is due for a hepatitis B vaccination Case 2":
Encounter."Two hepatitis B doses were administered"
and Encounter."The latest hepatitis B dose was administered more than 4 weeks ago"
and Encounter."The first hepatitis B dose was administered more 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="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for a hepatitis B vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for a hepatitis B vaccination
@pseudocode: "Immunization recommendation status" = "Due"
*/
define "Client is due for a hepatitis B vaccination":
"Client is due for a hepatitis B vaccination Case 1"
or "Client is due for a hepatitis B vaccination Case 2""/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is due for a hepatitis B vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for a hepatitis B vaccination Guidance
@guidance = Should vaccinate client with second hepatitis B dose as the latest hepatitis B dose was administered less than 4 weeks ago.
Check for contraindications.
@guidance = Should vaccinate client with third hepatitis B dose as the first hepatitis B dose was administered more than 6 months ago and the latest hepatitis B dose was administered more than 4 weeks ago.
Check for contraindications.
*/
define "Client is due for a hepatitis B vaccination Guidance":
case
when "Client is due for a hepatitis B vaccination Case 1" then 'Should vaccinate client with second hepatitis B dose as the latest hepatitis B dose was administered less than 4 weeks ago.
Check for contraindications.'
when "Client is due for a hepatitis B vaccination Case 2" then 'Should vaccinate client with third hepatitis B dose as the first hepatitis B dose was administered more than 6 months ago and the latest hepatitis B dose was administered more than 4 weeks ago.
Check for contraindications.'
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Three hepatitis B doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Three hepatitis B doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines") = 3
@code: Three hepatitis B doses were administered-93
@decision: IMMZ.D2.DT.Hepatitis B.Delayed start: 3-dose schedule (no birth dose + 3 doses), delayed start
*/
define "Three hepatitis B doses were administered":
"Number of Hepatitis B Doses Administered" = 3"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString value="Hepatitis B immunization schedule is complete"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Hepatitis B immunization schedule is complete
@pseudocode: '"Immunization recommendation status" = "Complete"
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Hepatitis B-containing vaccines")
*/
define "Hepatitis B immunization schedule is complete":
Encounter."Three hepatitis B doses were administered""/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString
value="Hepatitis B immunization schedule is complete Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Hepatitis B immunization schedule is complete Guidance
@guidance: Hepatitis B immunization schedule is complete. Three hepatitis B primary series doses were administered.
Check for any other vaccines due.
*/
define "Hepatitis B immunization schedule is complete Guidance":
'Hepatitis B immunization schedule is complete. Three hepatitis B primary series doses were administered.
Check for any other vaccines due.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</extension>
<extension url="name">
<valueString value="Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dynamicValue: Guidance
*/
define "Guidance":
case
when "Client is due for hepatitis B vaccination" then "Client is due for hepatitis B vaccination Guidance"
when "Client is not due for a hepatitis B vaccination" then "Client is not due for a hepatitis B vaccination Guidance"
when "Client is due for a hepatitis B vaccination" then "Client is due for a hepatitis B vaccination Guidance"
when "Hepatitis B immunization schedule is complete" then "Hepatitis B immunization schedule is complete Guidance"
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTHepatitisBDelayedStartLogic"/>
</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="30"/>
</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="31"/>
</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="32"/>
</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="33"/>
</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="34"/>
</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="35"/>
</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="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="earliest"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function earliest(immunizations List<Immunization>):
First(
immunizations I
sort by start of occurrence.toInterval()
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</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/IMMZD2DTHepatitisBEncounterElements"/>
</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 HepatitisBElements"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZD2DTHepatitisBElements"/>
</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 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 Encounter"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZEncounterElements"/>
</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="Value set Hepatitis B-containing vaccines"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE6"/>
</relatedArtifact>
<parameter>
<name value="Today"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="date"/>
</parameter>
<parameter>
<name value="HepBBirthDoseAgeLimitDays"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="integer"/>
</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 hepatitis B vaccination"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Client is due for a hepatitis B vaccination"/>
<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="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>
</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/IMMZD2DTHepatitisBDelayedStart"/>
<version value="0.2.0"/>
<name value="IMMZD2DTHepatitisBDelayedStart"/>
<title value="IMMZ.D2.DT.Hepatitis B.Delayed start"/>
<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.Hepatitis B.Delayed start
3-dose schedule (no birth dose + 3 doses), delayed start"/>
<relatedArtifact>
<type value="citation"/>
<citation
value="WHO recommendations for routine immunization - summary tables (January 2025)"/>
</relatedArtifact>
<library
value="http://smart.who.int/immunizations/Library/IMMZD2DTHepatitisBDelayedStartLogic"/>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="If delayed or interrupted scheduling of vaccination for children, adolescents and adults, 3 doses are recommended,
with the second dose administered at least 1 month after the first, and the third dose 6 months after the first dose. If the
vaccination schedule is interrupted, it is not necessary to restart the vaccine series."/>
</extension>
<title
value="Determine if the client is due for a hepatitis B vaccination according to the national immunization schedule"/>
<description
value="Determine if the client is due for a hepatitis B vaccination according to the national immunization schedule
3-dose schedule (no birth dose + 3 doses), delayed start"/>
<condition>
<kind value="applicability"/>
<expression>
<description value="Client is due for hepatitis B vaccination"/>
<language value="text/cql-identifier"/>
<expression value="Client is due for hepatitis B 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: 'DE6', display: 'Hepatitis B-containing vaccines' } }, display: 'Hepatitis B-containing vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="If delayed or interrupted scheduling of vaccination for children, adolescents and adults, 3 doses are recommended,
with the second dose administered at least 1 month after the first, and the third dose 6 months after the first dose. If the
vaccination schedule is interrupted, it is not necessary to restart the vaccine series."/>
</extension>
<title
value="Determine if the client is due for a hepatitis B vaccination according to the national immunization schedule"/>
<description
value="Determine if the client is due for a hepatitis B vaccination according to the national immunization schedule
3-dose schedule (no birth dose + 3 doses), delayed start"/>
<condition>
<kind value="applicability"/>
<expression>
<description value="Client is due for a hepatitis B vaccination"/>
<language value="text/cql-identifier"/>
<expression value="Client is due for a hepatitis B 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: 'DE6', display: 'Hepatitis B-containing vaccines' } }, display: 'Hepatitis B-containing vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<title
value="Check for Guidance for the patient regarding IMMZ.D2.DT.Hepatitis B.Delayed start."/>
<description
value="Show Guidance for the patient regarding IMMZ.D2.DT.Hepatitis B.Delayed start."/>
<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>