WHO Immunization Implementation Guide
1.0.0 - release
WHO Immunization Implementation Guide
1.0.0 - release
WHO Immunization Implementation Guide, published by WHO. This guide is not an authorized publication; it is the continuous build for version 1.0.0 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/132/merge and changes regularly. See the Directory of published versions
| Draft as of 2026-03-31 |
<Library xmlns="http://hl7.org/fhir">
<id value="IMMZD5DTDTPContraindicationsLogic"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablelibrary"/>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishablelibrary"/>
<profile
value="http://hl7.org/fhir/uv/cql/StructureDefinition/cql-library"/>
<profile
value="http://hl7.org/fhir/uv/cql/StructureDefinition/cql-module"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<div>
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">IMMZD5DTDTPContraindicationsLogic</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">IMMZD5DTDTPContraindicationsLogic</td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">1.0.0</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Library-IMMZD5DTDTPContraindicationsLogic.html">IMMZD5DTDTPContraindicationsLogic</a></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/7.1.0/CodeSystem-library-type.html">http://terminology.hl7.org/CodeSystem/library-type</a></span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>logic-library</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2026-03-31 13:54:17+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>This library defines decision support logic for the IMMZ.D5.DT.DTP contraindications decision table in the Immunization CPG</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Related Artifacts: </b></th>
<td style="padding-left: 4px;">
<p><b>Dependencies</b></p>
<ul>
<li><a href="Library-IMMZD5DTDTPEncounterElements.html">IMMZD5DTDTPEncounterElements</a></li>
</ul>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><th><b>Name</b></th><th><b>Type</b></th><th><b>Min</b></th><th><b>Max</b></th><th><b>In/Out</b></th></tr>
<tr><th>Today</th><th>date</th><th>0</th><th>1</th><th>In</th></tr>
<tr><th>Patient</th><th>Patient</th><th>0</th><th>1</th><th>Out</th></tr>
<tr><th>Draft Medication Request ID for Tetanus dose</th><th>id</th><th>0</th><th>1</th><th>Out</th></tr>
<tr><th>Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note</th><th>boolean</th><th>0</th><th>1</th><th>Out</th></tr>
<tr><th>Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note Guidance</th><th>string</th><th>0</th><th>1</th><th>Out</th></tr>
<tr><th>Tetanus vaccination is contraindicated</th><th>boolean</th><th>0</th><th>1</th><th>Out</th></tr>
<tr><th>Tetanus vaccination is contraindicated Guidance</th><th>string</th><th>0</th><th>1</th><th>Out</th></tr>
<tr><th>Guidance</th><th>string</th><th>0</th><th>1</th><th>Out</th></tr>
<tr><th>Has Guidance</th><th>boolean</th><th>0</th><th>1</th><th>Out</th></tr>
<tr><th>Test Validation</th><th>Resource</th><th>0</th><th>1</th><th>Out</th></tr>
</table>
</td>
</tr>
<tr>
<td colspan="2">
<table>
<tr><th><a id="cql-content"><b>Content: </b></a> text/cql</th></tr>
<tr><td><pre><code class="language-cql">/*
* Library: IMMZD5DTDTPContraindicationsLogic (IMMZ.D5.DT.DTP contraindications)
* Rule: Check for contraindications before administering the vaccine(s) due
* Decision Table: IMMZ.D5.DT.DTP contraindications
* Trigger: IMMZ.D5 Determine vaccine(s) to be administered based on contraindications
*/
library IMMZD5DTDTPContraindicationsLogic
using FHIR version '4.0.1'
include FHIRHelpers version '4.0.1'
include IMMZD5DTDTPEncounterElements called Encounter
parameter Today Date default Today()
context Patient
/*
@dynamicValue: Draft Medication Request ID for DTP dose
*/
define "Draft Medication Request ID for Tetanus dose":
First(Encounter."Draft Medication Request for Tetanus dose").id
/*
@dynamicValue: Guidance
*/
define "Guidance":
case
when "Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note" then "Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note Guidance"
when "Tetanus vaccination is contraindicated" then "Tetanus vaccination is contraindicated Guidance"
else ''
end
define "Has Guidance":
"Guidance" is not null and "Guidance" != ''
/*
@output: Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note
@pseudocode: "Immunization recommendation status" = "Further evaluation needed" (where "Vaccine type" = "Pertussis-containing vaccines")
AND
"Immunization recommendation status" = "Further evaluation needed" (where "Vaccine type" = "Tetanus-containing vaccines")
*/
define "Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note":
Encounter."The client has a history of anaphylactic reactions"
/*
@output: Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note Guidance
@guidance: Do not vaccinate client with pertussis and/or tetanus if the client has had a severe anaphylactic reaction to a vaccine component or reaction following a prior dose.
*/
define "Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note Guidance":
'Do not vaccinate client with pertussis and/or tetanus if the client has had a severe anaphylactic reaction to a vaccine component or reaction following a prior dose.'
/*
@output: Tetanus vaccination is contraindicated
@pseudocode: "Immunization recommendation status" = "Contraindicated" (where "Vaccine type" = "Tetanus -containing vaccines")
*/
define "Tetanus vaccination is contraindicated":
Encounter."The client currently has a severe acute illness"
/*
@output: Tetanus vaccination is contraindicated Guidance
@guidance: Do not vaccinate client with tetanus as tetanus vaccination is contraindicated for clients with severe acute illness
*/
define "Tetanus vaccination is contraindicated Guidance":
'Do not vaccinate client with tetanus as tetanus vaccination is contraindicated for clients with severe acute illness'
/*
@test: Test expected results based on example patients
*/
define "Test Validation":
case
when Patient.id = 'DTP88.1' then "Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note" and "Guidance" = 'Do not vaccinate client with pertussis and/or tetanus if the client has had a severe anaphylactic reaction to a vaccine component or reaction following a prior dose.'
when Patient.id = 'DTP89.1' then "Tetanus vaccination is contraindicated" and "Guidance" = 'Do not vaccinate client with tetanus as tetanus vaccination is contraindicated for clients with severe acute illness'
else 'No test case set'
end
</code></pre></td></tr>
</table>
</td>
</tr>
</table>
</div>
</div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
<valueCode value="computable"/>
</extension>
<url
value="http://smart.who.int/immunizations/Library/IMMZD5DTDTPContraindicationsLogic"/>
<version value="1.0.0"/>
<name value="IMMZD5DTDTPContraindicationsLogic"/>
<title value="IMMZD5DTDTPContraindicationsLogic"/>
<status value="draft"/>
<experimental value="false"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="logic-library"/>
</coding>
</type>
<date value="2026-03-31T13:54:17+00:00"/>
<publisher value="WHO"/>
<contact>
<name value="WHO"/>
<telecom>
<system value="url"/>
<value value="http://who.int"/>
</telecom>
</contact>
<description
value="This library defines decision support logic for the IMMZ.D5.DT.DTP contraindications decision table in the Immunization CPG"/>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Encounter"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZD5DTDTPEncounterElements"/>
</relatedArtifact>
<parameter>
<name value="Today"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="date"/>
</parameter>
<parameter>
<name value="Patient"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Patient"/>
</parameter>
<parameter>
<name value="Draft Medication Request ID for Tetanus dose"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="id"/>
</parameter>
<parameter>
<name
value="Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name
value="Tetanus and pertussis vaccination could be contraindicated. Clinical judgement is required. Create a clinical note Guidance"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Tetanus vaccination is contraindicated"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Tetanus vaccination is contraindicated Guidance"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Guidance"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Has Guidance"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Test Validation"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<content>
<contentType value="text/cql"/>
<data
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CBlbHNlICdObyB0ZXN0IGNhc2Ugc2V0JwogIGVuZAo="/>
</content>
</Library>