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="IMMZD5DTHPVContraindications"/>
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<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;">IMMZD5DTHPVContraindications</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD5DTHPVContraindications.html">IMMZ.D5.DT.HPV contraindications</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.D5.DT.HPV contraindications</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.D5.DT.HPV contraindications
IMMZ.D5.DT.HPV contraindications</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-IMMZD5DTHPVContraindicationsLogic.html">IMMZD5DTHPVContraindicationsLogic</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> Check for contraindications before administering the vaccine(s) due:</b> Contraindication for HPV immunization
<br/>
<b>If:</b>
<i>Applicability:</i>
Human papillomavirus (HPV) vaccination is contraindicated
<i>(Human papillomavirus (HPV) vaccination is contraindicated)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD5DTMR.html">IMMZD5DTMR</a><br/>
<i>Dynamic Values:</i><br/>
id: <i>(Draft Medication Request ID for HPV dose)</i>
<br/>
medication: <i>(Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE7', display: 'HPV vaccines' } }, display: 'HPV vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Check for Guidance for the patient regarding IMMZ.D5.DT.HPV contraindications.:</b> Show Guidance for the patient regarding IMMZ.D5.DT.HPV contraindications.
<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>
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<id value="effective-data-requirements"/>
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url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE161"/>
<display value="Potential contraindications"/>
</valueCoding>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE162"/>
<display value="Currently pregnant"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
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url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
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<code value="recurrence"/>
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url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
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<code value="relapse"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="82810-3"/>
<display value="Pregnancy status"/>
</valueCoding>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA15173-0"/>
<display value="Pregnant"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
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<code value="DE167"/>
<display value="Severe allergic reactions"/>
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@internal: Potential contraindications observations
*/
define "Potential contraindications":
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<valueString value="CI Currently pregnant Observation"/>
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<valueString
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*/
define "CI Currently pregnant Observation":
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*/
define "CI Currently pregnant Observation":
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<valueString value="CI Currently pregnant Condition"/>
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@internal: Condition for currently pregnant
*/
define "CI Currently pregnant Condition":
[Condition: Concepts."CI-Currently pregnant"]"/>
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<valueInteger value="3"/>
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@internal: Condition for currently pregnant
*/
define "CI Currently pregnant Condition":
Elements."CI Currently pregnant Condition" C
where C.prevalenceInterval() includes Today"/>
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<extension
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<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
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<extension url="name">
<valueString value="The client is pregnant"/>
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<extension url="statement">
<valueString
value="/*
@input: The client is pregnant
@pseudocode: "Potential contraindications" = "Currently pregnant"
*/
define "The client is pregnant":
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or exists "CI Currently pregnant Condition"
or exists WE."Pregnant Observation""/>
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<extension
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<extension url="libraryName">
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<valueString value="The client is currently pregnant"/>
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@input: The client is currently pregnant
@pseudocode: "Potential contraindications" = "Currently pregnant"
@code: The client is currently pregnant-52
@decision: IMMZ.D5.DT.HPV contraindications
*/
define "The client is currently pregnant":
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<valueInteger value="9"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
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<extension url="name">
<valueString
value="Human papillomavirus (HPV) vaccination is contraindicated"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Human papillomavirus (HPV) vaccination is contraindicated
@pseudocode: "Immunization recommendation status" = "Contraindicated"
*/
define "Human papillomavirus (HPV) vaccination is contraindicated":
Encounter."The client is currently pregnant""/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD5DTHPVContraindicationsLogic"/>
</extension>
<extension url="name">
<valueString
value="Human papillomavirus (HPV) vaccination is contraindicated Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Human papillomavirus (HPV) vaccination is contraindicated Guidance
@guidance: Do not vaccinate client with HPV as HPV vaccination is contraindicated for pregnant client.
*/
define "Human papillomavirus (HPV) vaccination is contraindicated Guidance":
'Do not vaccinate client with HPV as HPV vaccination is contraindicated for pregnant client.'"/>
</extension>
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<valueInteger value="11"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZElements"/>
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<extension url="name">
<valueString value="CI Severe allergic reactions Observation"/>
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<valueString
value="/*
@internal: Observation for Severe allergic reactions
*/
define "CI Severe allergic reactions Observation":
"Potential contraindications" O
where O.value ~ Concepts."CI-Severe allergic reactions""/>
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<valueInteger value="12"/>
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<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
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<extension url="name">
<valueString value="CI Severe allergic reactions Observation"/>
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<extension url="statement">
<valueString
value="/*
@internal: Observation for Severe allergic reactions
*/
define "CI Severe allergic reactions Observation":
Elements."CI Severe allergic reactions Observation".encounterOrOnBefore(EncounterId, Today)"/>
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<valueInteger value="13"/>
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<extension url="libraryName">
<valueString value="IMMZElements"/>
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<extension url="name">
<valueString value="CI Severe allergic reactions Condition"/>
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<extension url="statement">
<valueString
value="/*
@internal: Condition for Severe allergic reactions
*/
define "CI Severe allergic reactions Condition":
[Condition: Concepts."CI-Severe allergic reactions"]"/>
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<valueInteger value="14"/>
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<valueString value="CI Severe allergic reactions Condition"/>
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<extension url="statement">
<valueString
value="/*
@internal: Condition for Severe allergic reactions
*/
define "CI Severe allergic reactions Condition":
Elements."CI Severe allergic reactions Condition" C
where C.prevalenceInterval() includes Today"/>
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<valueInteger value="15"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
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<extension url="name">
<valueString
value="The client has history of severe allergic reactions"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The client has history of severe allergic reactions
@pseudocode: "Potential contraindications" = "Severe allergic reactions"
*/
define "The client has history of severe allergic reactions":
exists "CI Severe allergic reactions Observation"
or exists "CI Severe allergic reactions Condition""/>
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<extension url="libraryName">
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<extension url="name">
<valueString
value="The client has history of severe allergic reactions"/>
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<valueString
value="/*
@input: The client has history of severe allergic reactions
@pseudocode: "Potential contraindications" = "Severe allergic reactions"
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@decision: IMMZ.D5.DT.HPV contraindications
*/
define "The client has history of severe allergic reactions":
Encounter."The client has history of severe allergic reactions""/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
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<valueString
value="HPV vaccination could be contraindicated. Clinical judgement is required. Create a clinical note"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: HPV vaccination could be contraindicated. Clinical judgement is required. Create a clinical note
@pseudocode: "Immunization recommendation status" = "Further evaluation needed"
*/
define "HPV vaccination could be contraindicated. Clinical judgement is required. Create a clinical note":
Encounter."The client has history of severe allergic reactions""/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
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<valueString
value="HPV vaccination could be contraindicated. Clinical judgement is required. Create a clinical note Guidance"/>
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<extension url="statement">
<valueString
value="/*
@output: HPV vaccination could be contraindicated. Clinical judgement is required. Create a clinical note Guidance
@guidance: Do not vaccinate client with HPV if client has history of a severe allergic reaction after a previous HPV vaccine dose, or to a component of the vaccine.
*/
define "HPV vaccination could be contraindicated. Clinical judgement is required. Create a clinical note Guidance":
'Do not vaccinate client with HPV if client has history of a severe allergic reaction after a previous HPV vaccine dose, or to a component of the vaccine.'"/>
</extension>
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<extension
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<valueString
value="/*
@dynamicValue: Guidance
*/
define "Guidance":
case
when "Human papillomavirus (HPV) vaccination is contraindicated" then "Human papillomavirus (HPV) vaccination is contraindicated Guidance"
when "HPV vaccination could be contraindicated. Clinical judgement is required. Create a clinical note" then "HPV vaccination could be contraindicated. Clinical judgement is required. Create a clinical note Guidance"
else ''
end"/>
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<extension
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<extension url="libraryName">
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<valueString value="Draft Medication Request for Patient"/>
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<extension url="statement">
<valueString
value="/*
@dataElement: Draft Medication Request for Patient
*/
define "Draft Medication Request for Patient":
[MedicationRequest] MR where MR.status = 'draft' and MR.intent = 'proposal'
sort by date from (authoredOn as FHIR.dateTime) desc"/>
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<valueString value="Draft Medication Request for Patient"/>
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<valueString
value="/*
@dataElement: Draft Medication Request for Patient
*/
define "Draft Medication Request for Patient":
Elements."Draft Medication Request for Patient" MR
where MR.encounter.references(EncounterId)
or MR.authoredOn.toInterval() same day or before Today
sort by date from (authoredOn as FHIR.dateTime) desc"/>
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<extension url="libraryName">
<valueString value="IMMZD5DTHPVEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Draft Medication Request for HPV dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Draft Medication Request for HPV dose
*/
define "Draft Medication Request for HPV dose":
Encounter."Draft Medication Request for Patient" MR
where MR.medication in Concepts."HPV vaccines""/>
</extension>
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<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD5DTHPVContraindicationsLogic"/>
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<extension url="name">
<valueString value="Draft Medication Request ID for HPV dose"/>
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<extension url="statement">
<valueString
value="/*
@dynamicValue: Draft Medication Request ID for HPV dose
*/
define "Draft Medication Request ID for HPV dose":
First(Encounter."Draft Medication Request for HPV dose").id"/>
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observations O where O.status in { 'final', 'amended', 'corrected' }"/>
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<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="28"/>
</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="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="references"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if the given reference is to the given resourceId
@comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference FHIR.Reference, resourceId String):
resourceId = Last(Split(reference.reference, '/'))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</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="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="prevalenceInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns an interval representing the normalized prevalence period of a given Condition resource.
@comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition.
*/
define fluent function prevalenceInterval(condition Condition):
if condition.clinicalStatus ~ "active"
or condition.clinicalStatus ~ "recurrence"
or condition.clinicalStatus ~ "relapse" then
Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
(end of condition.abatementInterval()) abatementDate
return
if abatementDate is null then
Interval[start of condition.onset.toInterval(), abatementDate)
else
Interval[start of condition.onset.toInterval(), abatementDate]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="abatementInterval"/>
</extension>
<extension url="statement">
<valueString
value="// Was getting error on this for this particular choice set not being found
/*
@description: Returns an interval representing the normalized Abatement of a given Condition resource.
@comment: NOTE: Due to the complexity of determining an interval from a String, this function will throw
a run-time exception if used with a Condition instance that has a String as the abatement value.
*/
define fluent function abatementInterval(condition Condition):
if condition.abatement is FHIR.dateTime then
Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)]
else if condition.abatement is FHIR.Period then
FHIRHelpers.ToInterval(condition.abatement as FHIR.Period)
else if condition.abatement is FHIR.string then
Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')
else if condition.abatement is FHIR.Age then
Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age),
FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year)
else if condition.abatement is FHIR.Range then
Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low),
FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year)
else if condition.abatement is FHIR.boolean then
Interval[end of condition.onset.toInterval(), condition.recordedDate)
else
null"/>
</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="ToDateTime"/>
</extension>
<extension url="statement">
<valueString
value="define function ToDateTime(value dateTime): value.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="ToInterval"/>
</extension>
<extension url="statement">
<valueString
value="define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToDate"/>
</extension>
<extension url="statement">
<valueString
value="define function ToDate(value date): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToQuantity"/>
</extension>
<extension url="statement">
<valueString
value="define function ToQuantity(quantity FHIR.Quantity):
case
when quantity is null then null
when quantity.value is null then null
when quantity.comparator is not null then
Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')
when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'
or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then
System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }
else
Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')
end"/>
</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="ToCalendarUnit"/>
</extension>
<extension url="statement">
<valueString
value="define function ToCalendarUnit(unit System.String):
case unit
when 'ms' then 'millisecond'
when 's' then 'second'
when 'min' then 'minute'
when 'h' then 'hour'
when 'd' then 'day'
when 'wk' then 'week'
when 'mo' then 'month'
when 'a' then 'year'
else unit
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZCommon"/>
</extension>
<extension url="name">
<valueString value="encounterOrOnBefore"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @description: Gets observation from an encounter or on or before a date
*/
define fluent function encounterOrOnBefore(observations List<Observation>, EncounterId String, beforeDate Date):
observations O where
(O.encounter.references(EncounterId)
or O.effective.toInterval() starts same day or before beforeDate)"/>
</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="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value MedicationRequestStatus): 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="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value MedicationRequestIntent): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="41"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="toInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
From FHIRCommon 4.1.0:
*/
/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in FHIR, allowing this function to be used across any resource.
The input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.
If the input is a Period, the result is a DateTime Interval.
If the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.
If the input is an instant, the result is a DateTime Interval beginning and ending on that instant.
If the input is a string, an error is raised indicating a single interval cannot be computed from a string.
If the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,
and ending immediately prior to when the patient was the given Age plus one year.
If the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given
by the low end of the Range, and ending immediately prior to when the patient was the Age given by the
high end of the Range plus one year.
NOTE: Due to the
complexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used
with a Timing or String.
*/
define fluent function toInterval(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>):
case
when choice is FHIR.dateTime then
Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]
when choice is FHIR.Period then
FHIRHelpers.ToInterval(choice as FHIR.Period)
when choice is FHIR.instant then
Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]
when choice is FHIR.Age then
Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),
FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)
when choice is FHIR.Range then
Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),
FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)
when choice is FHIR.Timing then
Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')
when choice is FHIR.string then
Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')
else
null as Interval<DateTime>
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="42"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToDateTime"/>
</extension>
<extension url="statement">
<valueString
value="define function ToDateTime(value instant): value.value"/>
</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/IMMZD5DTHPVEncounterElements"/>
</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 Elements"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZElements"/>
</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 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 WE"/>
<resource
value="http://smart.who.int/immunizations/Library/WHOEncounterElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Elements"/>
<resource
value="http://smart.who.int/immunizations/Library/WHOElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Concepts"/>
<resource
value="http://smart.who.int/immunizations/Library/WHOConcepts"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Common"/>
<resource
value="http://smart.who.int/immunizations/Library/WHOCommon"/>
</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 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="Code system IMMZD"/>
<resource
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ConditionClinicalStatusCodes"/>
<resource
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system LOINC"/>
<resource value="http://loinc.org"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set HPV vaccines"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE7"/>
</relatedArtifact>
<parameter>
<name value="EncounterId"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Today"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="date"/>
</parameter>
<parameter>
<name value="AsOf"/>
<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="Draft Medication Request ID for HPV dose"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="id"/>
</parameter>
<parameter>
<name
value="Human papillomavirus (HPV) vaccination is contraindicated"/>
<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="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE161"/>
<display value="Potential contraindications"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE161"/>
<display value="Potential contraindications"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="encounter"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE161"/>
<display value="Potential contraindications"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE162"/>
<display value="Currently pregnant"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE162"/>
<display value="Currently pregnant"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="82810-3"/>
<display value="Pregnancy status"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="82810-3"/>
<display value="Pregnancy status"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="value"/>
<mustSupport value="encounter"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="82810-3"/>
<display value="Pregnancy status"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE161"/>
<display value="Potential contraindications"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE167"/>
<display value="Severe allergic reactions"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE167"/>
<display value="Severe allergic reactions"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
<mustSupport value="status"/>
<mustSupport value="intent"/>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
<mustSupport value="status"/>
<mustSupport value="intent"/>
<mustSupport value="encounter"/>
<mustSupport value="authoredOn"/>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
<mustSupport value="status"/>
<mustSupport value="intent"/>
<mustSupport value="encounter"/>
<mustSupport value="authoredOn"/>
<mustSupport value="medication"/>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE161"/>
<display value="Potential contraindications"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<code>
<system
value="http://smart.who.int/immunizations/CodeSystem/IMMZ.D"/>
<code value="DE167"/>
<display value="Severe allergic reactions"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
<mustSupport value="status"/>
<mustSupport value="intent"/>
<mustSupport value="encounter"/>
<mustSupport value="authoredOn"/>
<mustSupport value="medication"/>
</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/IMMZD5DTHPVContraindications"/>
<version value="0.2.0"/>
<name value="IMMZD5DTHPVContraindications"/>
<title value="IMMZ.D5.DT.HPV contraindications"/>
<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.D5.DT.HPV contraindications
IMMZ.D5.DT.HPV contraindications"/>
<relatedArtifact>
<type value="citation"/>
<citation
value="WHO recommendations for routine immunization - summary tables (January 2025)"/>
</relatedArtifact>
<library
value="http://smart.who.int/immunizations/Library/IMMZD5DTHPVContraindicationsLogic"/>
<action>
<title
value="Check for contraindications before administering the vaccine(s) due"/>
<description value="Contraindication for HPV immunization"/>
<condition>
<kind value="applicability"/>
<expression>
<description
value="Human papillomavirus (HPV) vaccination is contraindicated"/>
<language value="text/cql-identifier"/>
<expression
value="Human papillomavirus (HPV) vaccination is contraindicated"/>
</expression>
</condition>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/action-type"/>
<code value="update"/>
</coding>
</type>
<definitionCanonical
value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD5DTMR"/>
<dynamicValue>
<path value="id"/>
<expression>
<description value="Draft Medication Request ID for HPV dose"/>
<language value="text/cql-identifier"/>
<expression value="Draft Medication Request ID for HPV dose"/>
</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: 'DE7', display: 'HPV vaccines' } }, display: 'HPV vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<title
value="Check for Guidance for the patient regarding IMMZ.D5.DT.HPV contraindications."/>
<description
value="Show Guidance for the patient regarding IMMZ.D5.DT.HPV contraindications."/>
<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>