WHO Immunization Implementation Guide
0.1.0 - CI Build International flag

WHO Immunization Implementation Guide, published by World Health Organization (WHO). This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/WorldHealthOrganization/smart-immunizations and changes regularly. See the Directory of published versions

: IMMZDT01 - JSON Representation

Draft as of 2023-04-13

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{
  "resourceType" : "Library",
  "id" : "IMMZDT01",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Contents</h2><p><code>text/cql</code></p><pre><code class=\"language-sql\">/*\n * Library: IMMZDT01 (IMMZ.DT.01.BCG)\n * Rule: If child or person has not been vaccinated, give BCG vaccine as soon as possible after birth \n * Trigger: Patient has never had BCG vaccination\n */\nlibrary IMMZDT01\n// Start Skeleton CQL\nusing FHIR version '4.0.1'\ninclude FHIRHelpers version '4.0.1'\ninclude IMMZCommon called IMMZCom\ninclude IMMZConcepts called IMMZc\ninclude IMMZVaccineLibrary called IMMZvl\ninclude IMMZConfig called IMMZConf\n// End Skeleton CQL\ncontext Patient\n\n/*\n * Determine if the patient has risk of occupational exposure in low and high TB incidence areas (e.g. health\n * workers, laboratory workers, medical students, prison workers, other individuals with occupational exposure).\n * \n * The logic for determine this still needs to be determined.  Defaulting to true until this can be done.\n */\ndefine &quot;Risk of occupational exposure in low and high TB areas&quot;: true\n\n\n/*\n * Rule: Should vaccinate patient for BCG\n * Annotations:\n * \t - Provide BCG immunizations – using the &quot;BCG vaccine immunization – NO PREVIOUS&quot; schedule (1 dose scheme)\n * \t - \n * \t - Provide BCG immunizations – using the &quot;BCG vaccine immunization – NO PREVIOUS&quot; schedule (1 dose scheme) if CD4% &gt;25% for children aged &lt;5 years or CD4 count ≥200 if aged &gt;5  years\n * Outputs:\n * \t - Immunize Patient for BCG - TST-negative\n * \t - Immunize Patient for BCG - IGRA-negative\n * \t - Immunize Patient for BCG - No Doses\n * \t - Immunize Patient for BCG - History Unknown\n * \t - Immunize Patient for BCG - No Doses and HIV Status Positive and immunicologically stable\n * \t - \n * References:\n * \t- WHO recommendations for routine immunization - summary tables: https://www.who.int/teams/immunization-vaccines-and-biologicals/policies/who-recommendations-for-routine-immunization---summary-tables\n * \t- \n * Logic:\n *\t (((((((&quot;TST Test Result&quot; = &quot;TST-negative&quot;) and (&quot;High incidence of TB and/or high leprosy burden&quot; = true)) or ((&quot;IGRA Test Result&quot; = &quot;IGRA-negative&quot;) and (&quot;High incidence of TB and/or high leprosy burden&quot; = true))) or ((&quot;BCG vaccine immunization history&quot; = &quot;No-doses&quot;) and (&quot;High incidence of TB and/or high leprosy burden&quot; = true))) or ((&quot;BCG vaccine immunization history&quot; = &quot;Unknown&quot;) and (&quot;High incidence of TB and/or high leprosy burden&quot; = true))) or (((((&quot;BCG vaccine immunization history&quot; = &quot;No-doses&quot; = true) and (&quot;HIV Status&quot; = &quot;Positive&quot; = true)) and (&quot;CD4%&quot; &gt;&quot;25%&quot; = true)) and (&quot;Current Patient Age in Years&quot; &lt; 5)) and (&quot;High incidence of TB and/or high leprosy burden&quot; = true))) or (((((&quot;BCG vaccine immunization history&quot; = &quot;No-doses&quot; = true) and (&quot;HIV Status&quot; = &quot;Positive&quot; = true)) and (&quot;CD4 count&quot; ≥ &quot;200&quot; = true)) and (&quot;Current Patient Age in Years&quot; &gt; 5)) and (&quot;High incidence of TB and/or high leprosy burden&quot; = true)))\n * SHARING SCHEDULE LOGIC, KEEPING THIS FOR NOW IN CASE THAT DECISION CHANGES.\ndefine &quot;Should vaccinate patient for BCG&quot;:\n\tIMMZConf.&quot;High incidence of TB and/or high leprosy burden&quot; = true and (\n\t\tCoalesce((IMMZCom.&quot;Most Recent TST Test Result&quot; in IMMZc.&quot;Negative Result&quot;), false) or \n\t\tCoalesce((IMMZCom.&quot;Most Recent IGRA Test Result&quot; in IMMZc.&quot;Negative Result&quot;), false) or \n\t\t(IMMZCom.&quot;No BCG Doses Administered to Patient&quot;) or \n\t\t(\n\t\t\t\t(IMMZCom.&quot;No BCG Doses Administered to Patient&quot; and IMMZCom.&quot;HIV Status&quot; in IMMZc.&quot;HIV status - HIV positive Choices&quot;) and \n\t\t\t\t(\n\t\t\t\t\tCoalesce((IMMZCom.&quot;Most Recent CD4%&quot; &gt; 25'%' and IMMZCom.&quot;Current Patient Age In Years&quot; &lt; 5), false) or \n\t\t\t\t\tCoalesce((IMMZCom.&quot;Most Recent CD4 Count&quot; &gt;= 200 and IMMZCom.&quot;Current Patient Age In Years&quot; &gt;= 5), false)\n\t\t\t\t)\n\t\t)\n\t) \n*/\n\n/*\n * Rule: Provision of the BCG dose\n * Create Condition:\n *   - BCG dose should be provided if the patient has not received any BCG doses, and is in a High incidence of TB and/or high leprosy burden, and TST-negative and IGRA-negative\n * \n * Completion:\n *   - &quot;BCG Dose 1 provided&quot; = TRUE\n *\n * References:\n * \t- WHO recommendations for routine immunization - summary tables: https://www.who.int/teams/immunization-vaccines-and-biologicals/policies/who-recommendations-for-routine-immunization---summary-tables\n * \t \n */\ndefine &quot;Provision of the BCG dose&quot;:\n  IMMZCom.&quot;No BCG Doses Administered to Patient&quot; and\n  if IMMZCom.&quot;HIV Status&quot; in IMMZc.&quot;HIV status - HIV positive Choices&quot; \n\tthen \n\t\t(\n\t\t\tCoalesce((IMMZCom.&quot;Most Recent CD4%&quot; &gt; 25'%' and IMMZCom.&quot;Current Patient Age In Years&quot; &lt; 5), false) or \n\t\t\tCoalesce((IMMZCom.&quot;Most Recent CD4 Count&quot; &gt;= 200 and IMMZCom.&quot;Current Patient Age In Years&quot; &gt;= 5), false)\n\t\t)\n\telse \n\t\t(\n\t\t\tIMMZConf.&quot;High incidence of TB and/or high leprosy burden&quot; = true or\n\t\t\t(\n\t\t\t\t&quot;Risk of occupational exposure in low and high TB areas&quot; and (\n\t\t\t\t\tCoalesce((IMMZCom.&quot;Most Recent TST Test Result&quot; in IMMZc.&quot;Negative Result&quot;), false) or \n\t\t\t\t\tCoalesce((IMMZCom.&quot;Most Recent IGRA Test Result&quot; in IMMZc.&quot;Negative Result&quot;), false)\n\t\t\t\t)\n\t\t\t)\n\t\t)\n\ndefine &quot;Schedule Due Date for BCG dose&quot;:\n\tToDateTime( Patient.birthDate )\n\ndefine &quot;Should vaccinate patient for BCG&quot;:\n\t&quot;Provision of the BCG dose&quot; and (&quot;Schedule Due Date for BCG dose&quot; &lt;= (Now()))\n\t\n</code></pre></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
      "valueReference" : {
        "reference" : "Device/cqf-tooling"
      }
    }
  ],
  "url" : "http://fhir.org/guides/who/smart-immunization/Library/IMMZDT01",
  "version" : "0.1.0",
  "name" : "IMMZDT01",
  "status" : "draft",
  "date" : "2023-04-13T07:36:12+00:00",
  "publisher" : "World Health Organization (WHO)",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001"
        }
      ]
    }
  ],
  "content" : [
    {
      "contentType" : "text/cql",
      "data" : 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"
    }
  ]
}