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="IMMZD2DTMeaslesOngoingTransmission"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"/>
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value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareableplandefinition"/>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishableplandefinition"/>
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<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;">IMMZD2DTMeaslesOngoingTransmission</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD2DTMeaslesOngoingTransmission.html">IMMZ.D2.DT.Measles.Ongoing transmission</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.Measles.Ongoing transmission</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.Measles.Ongoing transmission
Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)</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-IMMZD2DTMeaslesOngoingTransmissionLogic.html">IMMZD2DTMeaslesOngoingTransmissionLogic</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 MCV1 in countries with ongoing transmission.:</b> Determine if the client is due for measles vaccination MCV1 according to the national immunization protocol.
Countries with ongoing transmission in which the risk of measles mortality remains high.
<br/>
<b>If:</b>
<i>Applicability:</i>
Client is due for MCV1
<i>(Client is due for MCV1)</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: 'DE9', display: 'Measles-containing vaccines' } }, display: 'Measles-containing vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Determine if the client is due for MCV2 in countries with ongoing transmission.:</b> Determine if the client is due for measles vaccination MCV2 according to the national immunization protocol.
Countries with ongoing transmission in which the risk of measles mortality remains high.
<br/>
<b>If:</b>
<i>Applicability:</i>
Client is due for MCV2
<i>(Client is due for MCV2)</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: 'DE9', display: 'Measles-containing vaccines' } }, display: 'Measles-containing vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Check for Guidance for the patient regarding IMMZ.D2.DT.Measles.Ongoing transmission.:</b> Show Guidance for the patient regarding IMMZ.D2.DT.Measles.Ongoing transmission.
<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>
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<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Current Patient Age In Months"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @dataElement Patient age in months
*/
define "Current Patient Age In Months":
AgeInMonthsAt(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Client's age is less than 9 months"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is less than 9 months
@pseudocode: Today's date − "Date of birth" < 9 months
@code: Client's age is less than 9 months-41
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
*/
define "Client's age is less than 9 months":
Encounter."Current Patient Age In Months" < 9"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for first dose of measles-containing vaccine (MCV1)"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for first dose of measles-containing vaccine (MCV1)
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for first dose of measles-containing vaccine (MCV1)":
Encounter."Client's age is less than 9 months""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for first dose of measles-containing vaccine (MCV1) Guidance"/>
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<extension url="statement">
<valueString
value="/*
@output: Client is not due for first dose of measles-containing vaccine (MCV1) Guidance
@guidance: Should not vaccinate client as client's age is less than 9 months.
Check for any vaccines due and inform the caregiver of when to come back for MCV1.
*/
define "Client is not due for first dose of measles-containing vaccine (MCV1) Guidance":
'Should not vaccinate client as client\'s age is less than 9 months.
Check for any vaccines due and inform the caregiver of when to come back for MCV1.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
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<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="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesElements"/>
</extension>
<extension url="name">
<valueString value="MCV Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: MCV Doses Administered to Patient
*/
define "MCV Doses Administered to Patient":
Elements."Doses Administered to Patient" I
where
I.vaccineCode in Concepts."Measles-containing vaccines""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesElements"/>
</extension>
<extension url="name">
<valueString
value="MCV Primary Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: MCV Primary Series Doses Administered to Patient
*/
define "MCV Primary Series Doses Administered to Patient":
"MCV Doses Administered to Patient".seriesPrimary()"/>
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<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="MCV Primary Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: MCV Primary Series Doses Administered to Patient
*/
define "MCV Primary Series Doses Administered to Patient":
MeaslesElements."MCV Primary Series Doses Administered to Patient".onOrBefore(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Number of MCV Primary Series Doses Administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Number of MCV Primary Series Doses Administered
*/
define "Number of MCV Primary Series Doses Administered":
Count("MCV Primary Series Doses Administered to Patient")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="No measles primary series doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No measles primary series doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Primary series") = 0
@code: No measles primary series doses were administered-127
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)
*/
define "No measles primary series doses were administered":
"Number of MCV Primary Series Doses Administered" = 0"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Client's age is more than or equal to 9 months"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is more than or equal to 9 months
@pseudocode: Today's date − "Date of birth" ≥ 9 months
@code: Client's age is more than or equal to 9 months-41
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration
*/
define "Client's age is more than or equal to 9 months":
Encounter."Current Patient Age In Months" >= 9"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZElements"/>
</extension>
<extension url="name">
<valueString value="Live Attenuated Vaccines"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: Live attenuated vaccines
*/
define "Live Attenuated Vaccines":
"Doses Administered to Patient" I
where I.vaccineCode in Concepts."Live Attenuated""/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Live Attenuated Vaccines"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement Live attenuated vaccines
*/
define "Live Attenuated Vaccines":
Elements."Live Attenuated Vaccines" I
where I.occurrence.toInterval() same day or before Today"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Date of Latest Live Attenuated Vaccine"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement Date and time of last live attenuated vaccine
*/
define "Date of Latest Live Attenuated Vaccine":
date from start of "Live Attenuated Vaccines".mostRecent().occurrence.toInterval()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Live vaccine was administered in the last 4 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Live vaccine was administered in the last 4 weeks
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) < 4 weeks
*/
define "Live vaccine was administered in the last 4 weeks":
"Date of Latest Live Attenuated Vaccine" is not null
and duration in weeks between "Date of Latest Live Attenuated Vaccine" and Today < 4"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="No live vaccine was administered in the last 4 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No live vaccine was administered in the last 4 weeks
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) ≥ 4 weeks
*/
define "No live vaccine was administered in the last 4 weeks":
not("Live vaccine was administered in the last 4 weeks")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="No live vaccine was administered in the last 4 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No live vaccine was administered in the last 4 weeks
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) ≥ 4 weeks
@code: No live vaccine was administered in the last 4 weeks-92
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration
*/
define "No live vaccine was administered in the last 4 weeks":
Encounter."No live vaccine was administered in the last 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for MCV1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for MCV1
@pseudocode: "Immunization recommendation status" = "Due"
*/
define "Client is due for MCV1":
Encounter."No measles primary series doses were administered"
and Encounter."Client's age is more than or equal to 9 months"
and Encounter."No live vaccine was administered in the last 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for MCV1 Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for MCV1 Guidance
@guidance: Should vaccinate client with MCV1 as no measles doses were administered, client is within appropriate age range and no live vaccine administered in the past 4 weeks.
Check for contraindications.
*/
define "Client is due for MCV1 Guidance":
'Should vaccinate client with MCV1 as no measles doses were administered, client is within appropriate age range and no live vaccine administered in the past 4 weeks.
Check for contraindications.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Live vaccine was administered in the last 4 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Live vaccine was administered in the last 4 weeks
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) < 4 weeks
@code: Live vaccine was administered in the last 4 weeks-92
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration
*/
define "Live vaccine was administered in the last 4 weeks":
Encounter."Live vaccine was administered in the last 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for MCV1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for MCV1
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for MCV1":
Encounter."No measles primary series doses were administered"
and Encounter."Client's age is more than or equal to 9 months"
and Encounter."Live vaccine was administered in the last 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for MCV1 Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for MCV1 Guidance
@guidance: Should not vaccinate client with MCV1 as live vaccine was administered in the past 4 weeks.
Check for any vaccines due and inform the caregiver of when to come back for MCV1.
*/
define "Client is not due for MCV1 Guidance":
'Should not vaccinate client with MCV1 as live vaccine was administered in the past 4 weeks.
Check for any vaccines due and inform the caregiver of when to come back for MCV1.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString value="MCV1 was administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: MCV1 was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Primary series") = 1
@code: MCV1 was administered-127
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)
*/
define "MCV1 was administered":
"Number of MCV Primary Series Doses Administered" = 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Client's age is less than 15 months"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is less than 15 months
@pseudocode: Today's date − "Date of birth" < 15 months
@code: Client's age is less than 15 months-42
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)
*/
define "Client's age is less than 15 months":
Encounter."Current Patient Age In Months" < 15"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for second dose of measles-containing vaccine (MCV2)"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for second dose of measles-containing vaccine (MCV2)
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for second dose of measles-containing vaccine (MCV2)":
Encounter."MCV1 was administered"
and Encounter."Client's age is less than 15 months""/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for second dose of measles-containing vaccine (MCV2) Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for second dose of measles-containing vaccine (MCV2) Guidance
@guidance: Should not vaccinate client with MCV2 as client's age is less than 15 months.
Check for any vaccines due and inform the caregiver of when to come back for MCV2.
*/
define "Client is not due for second dose of measles-containing vaccine (MCV2) Guidance":
'Should not vaccinate client with MCV2 as client\'s age is less than 15 months.
Check for any vaccines due and inform the caregiver of when to come back for MCV2.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Client's age is more than or equal to 15 months"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is more than or equal to 15 months
@pseudocode: Today's date − "Date of birth" ≥ 15 months
@code: Client's age is more than or equal to 15 months-42
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)
*/
define "Client's age is more than or equal to 15 months":
Encounter."Current Patient Age In Months" >= 15"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for MCV2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for MCV2
@pseudocode: "Immunization recommendation status" = "Due"
*/
define "Client is due for MCV2":
Encounter."MCV1 was administered"
and Encounter."Client's age is more than or equal to 15 months"
and Encounter."No live vaccine was administered in the last 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for MCV2 Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for MCV2 Guidance
@guidance: Should vaccinate client with MCV2 as client is within appropriate age range and no live vaccine administered in the past 4 weeks.
Check for contraindications.
*/
define "Client is due for MCV2 Guidance":
'Should vaccinate client with MCV2 as client is within appropriate age range and no live vaccine administered in the past 4 weeks.
Check for contraindications.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for MCV2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for MCV2
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for MCV2":
Encounter."MCV1 was administered"
and Encounter."Client's age is more than or equal to 15 months"
and Encounter."Live vaccine was administered in the last 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for MCV2 Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for MCV2 Guidance
@guidance: Should not vaccinate client with MCV2 as live vaccine was administered in the past 4 weeks.
Check for any vaccines due and inform the caregiver of when to come back for MCV2.
*/
define "Client is not due for MCV2 Guidance":
'Should not vaccinate client with MCV2 as live vaccine was administered in the past 4 weeks.
Check for any vaccines due and inform the caregiver of when to come back for MCV2.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesEncounterElements"/>
</extension>
<extension url="name">
<valueString value="MCV2 was administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: MCV2 was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Primary series") = 2
@code: MCV2 was administered-127
@decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)
@decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months)
*/
define "MCV2 was administered":
"Number of MCV Primary Series Doses Administered" = 2"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Measles primary series is complete"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Measles primary series is complete
@pseudocode: "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Measles-containing vaccines")
*/
define "Measles primary series is complete":
Encounter."MCV2 was administered""/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Measles primary series is complete Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Measles primary series is complete Guidance
@guidance: Measles primary series is complete. Two measles primary series doses were administered.
Check if a measles supplementary dose is appropriate for the client.
*/
define "Measles primary series is complete Guidance":
'Measles primary series is complete. Two measles primary series doses were administered.
Check if a measles supplementary dose is appropriate for the client.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</extension>
<extension url="name">
<valueString value="Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dynamicValue: Guidance
*/
define "Guidance":
case
when "Client is not due for first dose of measles-containing vaccine (MCV1)" then "Client is not due for first dose of measles-containing vaccine (MCV1) Guidance"
when "Client is due for MCV1" then "Client is due for MCV1 Guidance"
when "Client is not due for MCV1" then "Client is not due for MCV1 Guidance"
when "Client is not due for second dose of measles-containing vaccine (MCV2)" then "Client is not due for second dose of measles-containing vaccine (MCV2) Guidance"
when "Client is due for MCV2" then "Client is due for MCV2 Guidance"
when "Client is not due for MCV2" then "Client is not due for MCV2 Guidance"
when "Measles primary series is complete" then "Measles primary series is complete Guidance"
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTMeaslesOngoingTransmissionLogic"/>
</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="35"/>
</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="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZCommon"/>
</extension>
<extension url="name">
<valueString value="seriesPrimary"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @description: Gets the doses from the primary series
*/
define fluent function seriesPrimary(immunizations List<Immunization>):
immunizations I where
exists( I.protocolApplied pa where pa.series = 'Primary series' )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value string): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</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="39"/>
</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="40"/>
</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="41"/>
</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="42"/>
</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="43"/>
</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/IMMZD2DTMeaslesEncounterElements"/>
</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 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 MeaslesElements"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZD2DTMeaslesElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource
value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Elements"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource
value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Concepts"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZConcepts"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library WC"/>
<resource
value="http://smart.who.int/immunizations/Library/WHOCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Elements"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Concepts"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZConcepts"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Measles-containing vaccines"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE9"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Live Attenuated"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.LiveAttenuated"/>
</relatedArtifact>
<parameter>
<name value="Today"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="date"/>
</parameter>
<parameter>
<name value="Guidance"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Client is due for MCV2"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Client is due for MCV1"/>
<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="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"/>
</dataRequirement>
<dataRequirement>
<type value="Immunization"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<mustSupport value="status"/>
<mustSupport value="isSubpotent"/>
<mustSupport value="vaccineCode"/>
</dataRequirement>
<dataRequirement>
<type value="Immunization"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<mustSupport value="status"/>
<mustSupport value="isSubpotent"/>
<mustSupport value="vaccineCode"/>
</dataRequirement>
<dataRequirement>
<type value="Immunization"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<mustSupport value="status"/>
<mustSupport value="isSubpotent"/>
<mustSupport value="vaccineCode"/>
<mustSupport value="occurrence"/>
</dataRequirement>
<dataRequirement>
<type value="Immunization"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<mustSupport value="status"/>
<mustSupport value="isSubpotent"/>
<mustSupport value="vaccineCode"/>
</dataRequirement>
<dataRequirement>
<type value="Immunization"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<mustSupport value="status"/>
<mustSupport value="isSubpotent"/>
<mustSupport value="vaccineCode"/>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
<valueCode value="computable"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
<valueCanonical value="#effective-data-requirements"/>
</extension>
<url
value="http://smart.who.int/immunizations/PlanDefinition/IMMZD2DTMeaslesOngoingTransmission"/>
<version value="0.2.0"/>
<name value="IMMZD2DTMeaslesOngoingTransmission"/>
<title value="IMMZ.D2.DT.Measles.Ongoing transmission"/>
<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.Measles.Ongoing transmission
Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months)"/>
<relatedArtifact>
<type value="citation"/>
<citation
value="WHO recommendations for routine immunization - summary tables (January 2025)"/>
</relatedArtifact>
<library
value="http://smart.who.int/immunizations/Library/IMMZD2DTMeaslesOngoingTransmissionLogic"/>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="In countries with ongoing transmission in which the risk of measles mortality remains high, MCV1
should be given at 9 months of age. As a general rule, live vaccines should be given either simultaneously or
at intervals of 4 weeks. An exception to this rule is oral poliovirus vaccine (OPV), which can be given at any
time before or after measles vaccination without interference in the response to either vaccine."/>
</extension>
<title
value="Determine if the client is due for MCV1 in countries with ongoing transmission."/>
<description
value="Determine if the client is due for measles vaccination MCV1 according to the national immunization protocol.
Countries with ongoing transmission in which the risk of measles mortality remains high."/>
<condition>
<kind value="applicability"/>
<expression>
<description value="Client is due for MCV1"/>
<language value="text/cql-identifier"/>
<expression value="Client is due for MCV1"/>
</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: 'DE9', display: 'Measles-containing vaccines' } }, display: 'Measles-containing vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="In countries with ongoing transmission in which the risk of measles mortality remains high, MCV2
should be given at 15–18 months. The minimum interval between MCV1 and MCV2 is 4 weeks. As a general rule,
live vaccines should be given either simultaneously or at intervals of 4 weeks. An exception to this rule is
OPV, which can be given at any time before or after measles vaccination without interference in the response
to either vaccine."/>
</extension>
<title
value="Determine if the client is due for MCV2 in countries with ongoing transmission."/>
<description
value="Determine if the client is due for measles vaccination MCV2 according to the national immunization protocol.
Countries with ongoing transmission in which the risk of measles mortality remains high."/>
<condition>
<kind value="applicability"/>
<expression>
<description value="Client is due for MCV2"/>
<language value="text/cql-identifier"/>
<expression value="Client is due for MCV2"/>
</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: 'DE9', display: 'Measles-containing vaccines' } }, display: 'Measles-containing vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<title
value="Check for Guidance for the patient regarding IMMZ.D2.DT.Measles.Ongoing transmission."/>
<description
value="Show Guidance for the patient regarding IMMZ.D2.DT.Measles.Ongoing transmission."/>
<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>