Id: IMMZD18SDengue3DosesWithPreVaccinationScreening Url: IMMZ.D18.S.Dengue schedule Version: 1.0.0 Title: IMMZ.D18.S.Dengue 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.Dengue schedule CYD-TDV (Dengvaxia), 3-dose schedule Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD18SDengue3DosesWithPreVaccinationScreeningLogic Actions: Dengue dose 1: Provision of dengue dose 1 Trigger event: No dengue doses from primary series were administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 0 Trigger date: To be determined by Member States based on vaccination strategy Create condition: Dengue dose 1 should be provided based on vaccination strategy If: Applicability: Dengue dose 1 (Dengue dose 1) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Dengue 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' }) Dengue dose 2: Provision of the dengue dose 2 Trigger event: First dengue dose from the primary series was administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 1 Trigger date: "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") Create condition: Dengue dose 2 should be provided if the previous dose was provide more than 6 months ago If: Applicability: Dengue dose 2 (Dengue dose 2) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Dengue 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' }) Dengue dose 3: Provision of dengue dose 3 Trigger event: Second dengue dose from the primary series was administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 2 Trigger date: "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") Create condition: Dengue dose 3 should be provided if the previous dose was provide more than 6 months ago If: Applicability: Dengue dose 3 (Dengue dose 3) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Dengue dose 3 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' })
/* @dynamicValue: Dengue dose 2 Expiration @pseudocode: "Date of birth" + 46 years */ define "Dengue dose 2 Expiration": Patient.birthDate + 46 years
/** * @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: Dengue containing Doses Administered to Patient */ define "Dengue Doses Administered to Patient": Encounter."Doses Administered to Patient" I where I.vaccineCode in Concepts."Dengue vaccines"
Dengue Primary Series Doses Administered to Patient
/* @internal: Dengue containing Doses Administered to Patient that are in the Primary series */ define "Dengue Primary Series Doses Administered to Patient": "Dengue Doses Administered to Patient".seriesPrimary()
Number of Dengue Primary Series Doses Administered
/* @internal: Number of Dengue Primary Series doses */ define "Number of Dengue Primary Series Doses Administered": Count("Dengue Primary Series Doses Administered to Patient")
One dengue primary series dose was administered
/* @input: One dengue primary series dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 1 @code: One dengue primary series dose was administered-115 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "One dengue primary series dose was administered": "Number of Dengue Primary Series Doses Administered" = 1
First dengue dose from the primary series was administered
/* @complete: First dengue dose from the primary series was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 1 */ define "First dengue dose from the primary series was administered": Encounter."One dengue primary series dose was administered"
Two dengue primary series doses were administered
/* @input: Two dengue primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 2 @code: Two dengue primary series doses were administered-115 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "Two dengue primary series doses were administered": "Number of Dengue Primary Series Doses Administered" = 2
Second dengue dose from the primary series was administered
/* @complete: Second dengue dose from the primary series was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 2 */ define "Second dengue dose from the primary series was administered": Encounter."Two dengue primary series doses were administered"
/* @output: Dengue dose 2 @description: Provision of the dengue dose 2 @trigger: First dengue dose from the primary series was administered @pseudo: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 1 @triggerDate: "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") */ define "Dengue dose 2": "Dengue dose 2 Expiration" > Today and "First dengue dose from the primary series was administered" and not "Second dengue dose from the primary series was administered"
/* @internal: Date of Latest Dengue Dose */ define "Date of Latest Dengue Dose": date from start of "Dengue Doses Administered to Patient".mostRecent().occurrence.toInterval()
/* @dynamicValue: Dengue dose 2 Due Date @pseudocode: "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") + 6 months */ define "Dengue dose 2 Due Date": if "Dengue dose 2" then Encounter."Date of Latest Dengue Dose" + 6 months else null
/* @output: Dengue dose 2 Create @create: Dengue dose 2 should be provided if the previous dose was provide more than 6 months ago */ define "Dengue dose 2 Create": if "Dengue dose 2" then 'Dengue dose 2 should be provided if the previous dose was provide more than 6 months ago' + ' Due Date: ' + ToString("Dengue dose 2 Due Date") + ' Expiration: ' + ToString("Dengue dose 2 Expiration") else ''
/** * @dataElement Patient age in years */ define "Current Patient Age In Years": AgeInYearsAt(Today)
/* @input: Client's age is more than 45 years @pseudocode: Today's date − "Date of birth" > 45 years @code: Client's age is more than 45 years-41 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "Client's age is more than 45 years": Encounter."Current Patient Age In Years" > 45
/* @dynamicValue: Dengue dose 1 Expiration @pseudocode: "Date of birth" + 46 years */ define "Dengue dose 1 Expiration": Patient.birthDate + 46 years
No dengue primary series doses were administered
/* @input: No dengue primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 0 @code: No dengue primary series doses were administered-115 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "No dengue primary series doses were administered": "Number of Dengue Primary Series Doses Administered" = 0
/* @output: Dengue dose 1 @description: Provision of dengue dose 1 @trigger: No dengue doses from primary series were administered @pseudo: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 0 @triggerDate: To be determined by Member States based on vaccination strategy */ define "Dengue dose 1": not Encounter."Client's age is more than 45 years" and "Dengue dose 1 Expiration" > Today and Encounter."No dengue primary series doses were administered" and not "First dengue dose from the primary series was administered"
Three dengue primary series doses were administered
/* @input: Three dengue primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 3 @code: Three dengue primary series doses were administered-115 @decision: IMMZ.D2.DT.Dengue.3 doses with pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule with pre-vaccination screening, the recommended strategy where feasible (pre-vaccination screening whereby only those tested seropositive would be vaccinated) @decision: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening: CYD-TDV (Dengvaxia), 3-dose schedule without pre-vaccination screening [when pre-vaccination screening is not feasible and in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years] */ define "Three dengue primary series doses were administered": "Number of Dengue Primary Series Doses Administered" = 3
Third dengue dose from the primary series was administered. The primary series has been completed
/* @complete: Third dengue dose from the primary series was administered. The primary series has been completed @pseudocode: "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Dengue vaccines")" */ define "Third dengue dose from the primary series was administered. The primary series has been completed": Encounter."Three dengue primary series doses were administered"
/* @output: Dengue dose 3 @description: Provision of dengue dose 3 @trigger: Second dengue dose from the primary series was administered @pseudo: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 2 @triggerDate: "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") */ define "Dengue dose 3": "Dengue dose 2 Expiration" > Today and "Second dengue dose from the primary series was administered" and not "Third dengue dose from the primary series was administered. The primary series has been completed"
/* @dynamicValue: Dengue dose 1 Due Date @pseudocode: "Date of birth" + 9 years */ define "Dengue dose 1 Due Date": if "Dengue dose 1" then Patient.birthDate + 9 years else null
/* @output: Dengue dose 1 Create @create: Dengue dose 1 should be provided based on vaccination strategy */ define "Dengue dose 1 Create": if "Dengue dose 1" then 'Dengue dose 1 should be provided based on vaccination strategy' + ' Due Date: ' + ToString("Dengue dose 1 Due Date") + ' Expiration: ' + ToString("Dengue dose 1 Expiration") else ''
/* @dynamicValue: Dengue dose 3 Due Date @pseudocode: "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") + 6 months */ define "Dengue dose 3 Due Date": if "Dengue dose 3" then Encounter."Date of Latest Dengue Dose" + 6 months else null
/* @dynamicValue: Dengue dose 3 Expiration @pseudocode: "Date of birth" + 46 years */ define "Dengue dose 3 Expiration": Patient.birthDate + 46 years
/* @output: Dengue dose 3 Create @create: Dengue dose 3 should be provided if the previous dose was provide more than 6 months ago */ define "Dengue dose 3 Create": if "Dengue dose 3" then 'Dengue dose 3 should be provided if the previous dose was provide more than 6 months ago' + ' Due Date: ' + ToString("Dengue dose 3 Due Date") + ' Expiration: ' + ToString("Dengue dose 3 Expiration") else ''
define function ToDate(value date): value.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' )
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 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() )
IMMZ.D18.S.Dengue schedule CYD-TDV (Dengvaxia), 3-dose schedule
WHO recommendations for routine immunization - summary tables (January 2025)
Provision of dengue dose 1 Trigger event: No dengue doses from primary series were administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 0 Trigger date: To be determined by Member States based on vaccination strategy Create condition: Dengue dose 1 should be provided based on vaccination strategy
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }
Provision of the dengue dose 2 Trigger event: First dengue dose from the primary series was administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 1 Trigger date: "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") Create condition: Dengue dose 2 should be provided if the previous dose was provide more than 6 months ago
Provision of dengue dose 3 Trigger event: Second dengue dose from the primary series was administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Dengue vaccines" and "Type of dose" = "Primary series") = 2 Trigger date: "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") Create condition: Dengue dose 3 should be provided if the previous dose was provide more than 6 months ago