Id: IMMZD18SCholeraWCVaccines Url: IMMZ.D18.S.Cholera.WC vaccines schedule Version: 1.0.0 Title: IMMZ.D18.S.Cholera.WC vaccines schedule Status: draft Type: system: http://terminology.hl7.org/CodeSystem/plan-definition-type code: eca-rule Date: 2026-03-31 13:54:17+0000 Publisher: WHO Description: IMMZ.D18.S.Cholera.WC vaccines schedule Whole-cell (WC) vaccines (Shanchol, Euvchol and mORCVAX), 2-dose schedule Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD18SCholeraWCVaccinesLogic Actions: Cholera dose 1: Provision of the cholera dose 1 Trigger event: Child's birth and no cholera doses have been administered Trigger pseudo: Child's birth AND Count of vaccines administered (where "Vaccine type" = "Cholera vaccines" and "Type of dose" = "Primary series") = 0 Trigger date: "Date of birth" OR Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") Create condition: WC vaccines: 2 doses should be given 14 days apart to individuals aged ≥ 1 year. Revaccination is recommended where there is continued risk of Vibrio cholerae infection. For WC vaccines, revaccination is recommended after 3 years. If: Applicability: Cholera dose 1 (Cholera dose 1) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Cholera dose 1 Create) category.coding: (Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }) priority: (Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }) Cholera dose 2: Provision of the cholera dose 2 Trigger event: First cholera dose administered Trigger pseudo: Latest "Dose number" (where "Vaccine type" = "Cholera vaccines"and "Type of dose" = "Primary series") = 1 Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") Create condition: WC vaccines: 2 doses should be given 14 days apart to individuals aged ≥ 1 year. If: Applicability: Cholera dose 2 (Cholera dose 2) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Cholera dose 2 Create) category.coding: (Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }) priority: (Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }) Cholera booster dose 1: Provision of the cholera booster dose 1 Trigger event: Primary series for cholera has been completed and latest cholera dose was administered more than 3 years ago Trigger pseudo: "Completed the primary vaccination series" (where "Vaccine type" = "Cholera vaccines") = TRUE AND Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") ≥ 3 years Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") Create condition: For WC vaccines, revaccination is recommended after 3 years. If: Applicability: Cholera booster dose 1 (Cholera booster dose 1) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Cholera booster dose 1 Create) category.coding: (Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }) priority: (Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }) Cholera booster dose 2: Provision of the cholera booster dose 1 Trigger event: First cholera booster dose administered Trigger pseudo: Latest "Dose number" (where "Vaccine type" = "Cholera vaccines"and "Type of dose" = "Booster dose") = 1 Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") Create condition: For WC vaccines, revaccination is recommended after 3 years. If: Applicability: Cholera booster dose 2 (Cholera booster dose 2) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Cholera booster dose 2 Create) category.coding: (Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }) priority: (Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })
/** * @dataElement All Doses Administered to Patient */ define "Doses Administered to Patient": [Immunization] I where I.status = 'completed' and I.isSubpotent is not true
/** * @dataElement All Doses Administered to Patient */ define "Doses Administered to Patient": Elements."Doses Administered to Patient" I where I.occurrence.toInterval() same day or before Today
/* @internal: Cholera containing Doses Administered to Patient */ define "Cholera Doses Administered to Patient": Encounter."Doses Administered to Patient" I where I.vaccineCode in Concepts."Cholera vaccines"
Cholera Primary Series Doses Administered to Patient
/* @internal: Cholera containing Doses Administered to Patient that are in the Primary series */ define "Cholera Primary Series Doses Administered to Patient": "Cholera Doses Administered to Patient".seriesPrimary()
Number of Cholera Primary Series Doses Administered
/* @internal: Number of Cholera Primary Series doses */ define "Number of Cholera Primary Series Doses Administered": Count("Cholera Primary Series Doses Administered to Patient")
One cholera primary series dose was administered
/* @input: One cholera primary series dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Cholera vaccines" and "Type of dose" = "Primary series") = 1 @code: One cholera primary series dose was administered-116 @decision: IMMZ.D2.DT.Cholera.WC vaccines: Whole-cell (WC) vaccines schedule */ define "One cholera primary series dose was administered": "Number of Cholera Primary Series Doses Administered" = 1
/* @complete: First cholera dose was administered @pseudocode: 'Latest "Dose number" (where "Vaccine type" = "Cholera vaccines" and "Type of dose" = "Primary series") = 1 */ define "First cholera dose was administered": Encounter."One cholera primary series dose was administered"
Two cholera primary series doses were administered
/* @input: Two cholera primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Cholera vaccines" and "Type of dose" = "Primary series") = 2 @code: Two cholera primary series doses were administered-116 @decision: IMMZ.D2.DT.Cholera.WC vaccines: Whole-cell (WC) vaccines schedule */ define "Two cholera primary series doses were administered": "Number of Cholera Primary Series Doses Administered" = 2
/* @complete: The primary series has been completed @pseudocode: "Completed the primary vaccination series" (where "Vaccine type" = "Cholera vaccines") = TRUE */ define "The primary series has been completed": Encounter."Two cholera primary series doses were administered"
/* @output: Cholera dose 2 @description: Provision of the cholera dose 2 @trigger: First cholera dose administered @pseudo: Latest "Dose number" (where "Vaccine type" = "Cholera vaccines"and "Type of dose" = "Primary series") = 1 @triggerDate: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") */ define "Cholera dose 2": "First cholera dose was administered" and not "The primary series has been completed"
/* @internal: Date of Latest Cholera Dose */ define "Date of Latest Cholera Dose": date from start of "Cholera Doses Administered to Patient".mostRecent().occurrence.toInterval()
/* @dynamicValue: Cholera dose 2 Due Date @pseudocode: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") + 2 weeks */ define "Cholera dose 2 Due Date": if "Cholera dose 2" then Encounter."Date of Latest Cholera Dose" + 2 weeks else null
/* @output: Cholera dose 2 Create @create: WC vaccines: 2 doses should be given 14 days apart to individuals aged ≥ 1 year. */ define "Cholera dose 2 Create": if "Cholera dose 2" then 'WC vaccines: 2 doses should be given 14 days apart to individuals aged ≥ 1 year.' + ' Due Date: ' + ToString("Cholera dose 2 Due Date") else ''
Cholera Booster Series Doses Administered to Patient
/* @internal: Cholera Booster Series Doses Administered to Patient */ define "Cholera Booster Series Doses Administered to Patient": "Cholera Doses Administered to Patient".seriesBooster()
Number of Cholera Booster Series Doses Administered
/* @internal: Number of Cholera Booster Series Doses Administered */ define "Number of Cholera Booster Series Doses Administered": Count("Cholera Booster Series Doses Administered to Patient")
At least one booster series dose was administered
/* @input: At least one booster series dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Cholera vaccines" and "Type of dose" = "Booster dose") >= 1 @code: At least one booster series dose was administered-115 @decision: IMMZ.D2.DT.Cholera.WC vaccines: Whole-cell (WC) vaccines schedule */ define "At least one booster series dose was administered": "Number of Cholera Booster Series Doses Administered" >= 1
/* @input: Dose number of the latest dose is one @pseudocode: Latest "Dose number" (where "Vaccine type" = "Cholera vaccines") = 1 @code: Dose number of the latest dose is one-68 @decision: IMMZ.D2.DT.Cholera.WC vaccines: Whole-cell (WC) vaccines schedule */ define "Dose number of the latest dose is one": "Cholera Doses Administered to Patient".mostRecent().getDose('1') is not null
First cholera booster dose was administered
/* @complete: First cholera booster dose was administered @pseudocode: 'Latest "Dose number" (where "Vaccine type" = "Cholera vaccines" and "Type of dose" = "Booster dose") = 1 */ define "First cholera booster dose was administered": Encounter."At least one booster series dose was administered" and Encounter."Dose number of the latest dose is one"
/* @output: Cholera booster dose 1 @description: Provision of the cholera booster dose 1 @trigger: Primary series for cholera has been completed and latest cholera dose was administered more than 3 years ago @pseudo: "Completed the primary vaccination series" (where "Vaccine type" = "Cholera vaccines") = TRUE AND Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") ≥ 3 years @triggerDate: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") */ define "Cholera booster dose 1": "The primary series has been completed" and not "First cholera booster dose was administered"
/* @dynamicValue: Cholera booster dose 1 Due Date @pseudocode: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") + 2 weeks */ define "Cholera booster dose 1 Due Date": if "Cholera booster dose 1" then Encounter."Date of Latest Cholera Dose" + 3 years else null
/* @output: Cholera booster dose 1 Create @create: For WC vaccines, revaccination is recommended after 3 years. */ define "Cholera booster dose 1 Create": if "Cholera booster dose 1" then 'For WC vaccines, revaccination is recommended after 3 years.' + ' Due Date: ' + ToString("Cholera booster dose 1 Due Date") else ''
/* @input: Dose number of the latest dose is two @pseudocode: Latest "Dose number" (where "Vaccine type" = "Cholera vaccines") = 2 @code: Dose number of the latest dose is two-68 @decision: IMMZ.D2.DT.Cholera.WC vaccines: Whole-cell (WC) vaccines schedule */ define "Dose number of the latest dose is two": "Cholera Doses Administered to Patient".mostRecent().getDose('2') is not null
Revaccination with booster series has been completed in the last 3 years
/* @complete: Revaccination with booster series has been completed in the last 3 years @pseudocode: "Completed the booster series" (where "Vaccine type" = "Cholera vaccines") = TRUE AND Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccine") < 3 years */ define "Revaccination with booster series has been completed in the last 3 years": Encounter."At least one booster series dose was administered" and Encounter."Dose number of the latest dose is two"
/* @output: Cholera booster dose 2 @description: Provision of the cholera booster dose 1 @trigger: First cholera booster dose administered @pseudo: Latest "Dose number" (where "Vaccine type" = "Cholera vaccines"and "Type of dose" = "Booster dose") = 1 @triggerDate: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") */ define "Cholera booster dose 2": "First cholera booster dose was administered" and not "Revaccination with booster series has been completed in the last 3 years"
No cholera primary series dose was administered
/* @input: No cholera primary series dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Cholera vaccines" and "Type of dose" = "Primary series") = 0 @code: No cholera primary series dose was administered-116 @decision: IMMZ.D2.DT.Cholera.WC vaccines: Whole-cell (WC) vaccines schedule @decision: IMMZ.D2.DT.Cholera.WC-rBS vaccine 3 doses: Whole cell-recombinant B subunit (WC-rBS) vaccine, 3-dose schedule for clients aged 2–5 years @decision: IMMZ.D2.DT.Cholera.WC-rBS vaccine 2 doses: Whole cell-recombinant B subunit (WC-rBS) vaccine, 2-dose schedule for clients aged over 5 years */ define "No cholera primary series dose was administered": "Number of Cholera Primary Series Doses Administered" = 0
/* @output: Cholera dose 1 @description: Provision of the cholera dose 1 @trigger: Child's birth and no cholera doses have been administered @pseudo: Child's birth AND Count of vaccines administered (where "Vaccine type" = "Cholera vaccines" and "Type of dose" = "Primary series") = 0 @triggerDate: "Date of birth" OR Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") */ define "Cholera dose 1": Encounter."No cholera primary series dose was administered" and not "First cholera dose was administered"
/* @dynamicValue: Cholera booster dose 2 Due Date @pseudocode: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") + 3 years */ define "Cholera booster dose 2 Due Date": if "Cholera booster dose 2" then Encounter."Date of Latest Cholera Dose" + 2 weeks else null
/* @output: Cholera booster dose 2 Create @create: For WC vaccines, revaccination is recommended after 3 years. */ define "Cholera booster dose 2 Create": if "Cholera booster dose 2" then 'For WC vaccines, revaccination is recommended after 3 years.' + ' Due Date: ' + ToString("Cholera booster dose 2 Due Date") else ''
/* @dynamicValue: Cholera dose 1 Due Date @pseudocode: "Date of birth" + 1 year */ define "Cholera dose 1 Due Date": if "Cholera dose 1" then Patient.birthDate + 1 year else null
/* @output: Cholera dose 1 Create @create: WC vaccines: 2 doses should be given 14 days apart to individuals aged ≥ 1 year. Revaccination is recommended where there is continued risk of Vibrio cholerae infection. For WC vaccines, revaccination is recommended after 3 years. */ define "Cholera dose 1 Create": if "Cholera dose 1" then 'WC vaccines: 2 doses should be given 14 days apart to individuals aged ≥ 1 year. Revaccination is recommended where there is continued risk of Vibrio cholerae infection. For WC vaccines, revaccination is recommended after 3 years.' + ' Due Date: ' + ToString("Cholera dose 1 Due Date") else ''
/** * @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' )
define function ToString(value string): value.value
define function ToString(value ImmunizationStatus): value.value
define function ToBoolean(value boolean): value.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
define function ToDateTime(value dateTime): value.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]
define function ToDateTime(value instant): value.value
define function ToDate(value date): value.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
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
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 }
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 }
define fluent function mostRecent(immunizations List<Immunization>): Last( immunizations I sort by start of occurrence.toInterval() )
/** * @description: Gets the doses from the Booster series */ define fluent function seriesBooster(immunizations List<Immunization>): immunizations I where exists( I.protocolApplied pa where pa.series = 'Booster dose' )
/** * @description: Gets a given immunization from a list that matches the dose number */ define fluent function getDose(immunization Immunization, doseNumber String): immunization I where exists( I.protocolApplied pa where pa.doseNumber = doseNumber )
IMMZ.D18.S.Cholera.WC vaccines schedule Whole-cell (WC) vaccines (Shanchol, Euvchol and mORCVAX), 2-dose schedule
WHO recommendations for routine immunization - summary tables (January 2025)
Provision of the cholera dose 1 Trigger event: Child's birth and no cholera doses have been administered Trigger pseudo: Child's birth AND Count of vaccines administered (where "Vaccine type" = "Cholera vaccines" and "Type of dose" = "Primary series") = 0 Trigger date: "Date of birth" OR Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") Create condition: WC vaccines: 2 doses should be given 14 days apart to individuals aged ≥ 1 year. Revaccination is recommended where there is continued risk of Vibrio cholerae infection. For WC vaccines, revaccination is recommended after 3 years.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }
Provision of the cholera dose 2 Trigger event: First cholera dose administered Trigger pseudo: Latest "Dose number" (where "Vaccine type" = "Cholera vaccines"and "Type of dose" = "Primary series") = 1 Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") Create condition: WC vaccines: 2 doses should be given 14 days apart to individuals aged ≥ 1 year.
Provision of the cholera booster dose 1 Trigger event: Primary series for cholera has been completed and latest cholera dose was administered more than 3 years ago Trigger pseudo: "Completed the primary vaccination series" (where "Vaccine type" = "Cholera vaccines") = TRUE AND Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") ≥ 3 years Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") Create condition: For WC vaccines, revaccination is recommended after 3 years.
Provision of the cholera booster dose 1 Trigger event: First cholera booster dose administered Trigger pseudo: Latest "Dose number" (where "Vaccine type" = "Cholera vaccines"and "Type of dose" = "Booster dose") = 1 Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Cholera vaccines") Create condition: For WC vaccines, revaccination is recommended after 3 years.