Id: IMMZD18SHPVSingleDose Url: IMMZ.D18.S.Single-dose schedule Version: 1.0.0 Title: IMMZ.D18.S.Single-dose 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.Single-dose schedule Alternative single-dose schedule Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD18SHPVSingleDoseLogic Actions: Human papillomavirus (HPV) dose 1: Provision of the HPV dose 1 Trigger event: Child's birth Trigger pseudo: Trigger date: "Date of birth" Create condition: HPV dose 1 should be provided if the client is older than 9 years of age. If: Applicability: Human papillomavirus (HPV) dose 1 (Human papillomavirus (HPV) dose 1) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Human papillomavirus (HPV) 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' }) HPV dose 2 (Immunocompromised or HIV-positive): Provision of the HPV dose 2 for individuals immunocompromised or infected with HIV Trigger event: First HPV dose from the primary series was administered and client's HIV status is positive or client is immunocompromised Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "HPV vaccines") = 1 AND ("HIV status" = "HIV-positive" OR "Immunocompromised" = TRUE) Trigger date: "Date and time of vaccination" (where "Vaccine type" = "HPV vaccines") Create condition: Individuals known to be immunocompromised or infected with HIV should receive at least two HPV vaccine doses. If: Applicability: HPV dose 2 (Immunocompromised or HIV-positive) (HPV dose 2 (Immunocompromised or HIV-positive)) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (HPV dose 2 (Immunocompromised or HIV-positive) 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' }) HPV dose 3 (Immunocompromised or HIV-positive): Provision of the HPV dose 3 for individuals immunocompromised or infected with HIV Trigger event: Second HPV dose from the primary series was administered and client's HIV status is positive or client is immunocompromised Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "HPV vaccines") = 2 AND ("HIV status" = "HIV-positive" OR "Immunocompromised" = TRUE) Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "HPV vaccines") Create condition: Where possible, three HPV doses should be provided to individuals known to be immunocompromised or infected with HIV. If: Applicability: HPV dose 3 (Immunocompromised or HIV-positive) (HPV dose 3 (Immunocompromised or HIV-positive)) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (HPV dose 3 (Immunocompromised or HIV-positive) 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: HPV containing Doses Administered to Patient */ define "HPV Doses Administered to Patient": Encounter."Doses Administered to Patient" I where I.vaccineCode in Concepts."HPV vaccines"
HPV Primary Series Doses Administered to Patient
/* @internal: HPV containing Doses Administered to Patient that are in the Primary series */ define "HPV Primary Series Doses Administered to Patient": "HPV Doses Administered to Patient".seriesPrimary()
Number of HPV Primary Series Doses Administered
/* @internal: Number of HPV Primary Series doses */ define "Number of HPV Primary Series Doses Administered": Count("HPV Primary Series Doses Administered to Patient")
Two HPV primary series doses were administered
/* @input: Two HPV primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "HPV vaccines" and "Type of dose" = "Primary series") = 2 @code: Two HPV primary series doses were administered-112 @decision: IMMZ.D2.DT.HPV.2 doses: 2-dose schedule @decision: IMMZ.D2.DT.HPV.Single dose: Alternative single-dose schedule */ define "Two HPV primary series doses were administered": "Number of HPV Primary Series Doses Administered" = 2
Second HPV dose from the primary series was administered
/* @complete: Second HPV dose from the primary series was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "HPV vaccines") = 2 */ define "Second HPV dose from the primary series was administered": Encounter."Two HPV primary series doses were administered"
/* @internal: HIV Status Observation */ define "HIV status Observation": ([Observation: Concepts."HIV status"]).complete()
/* @input: Client's HIV status is positive @pseudocode: "HIV status" = "HIV-positive" */ define "Client's HIV status is positive": exists( (Elements."HIV status Observation".encounterOrOnBefore(EncounterId, Today)) O where O.value ~ Concepts."HIV-positive" )
/* @input: Client's HIV status is positive @pseudocode: "HIV status" = "HIV-positive" @code: Client's HIV status is positive-29 @decision: IMMZ.D2.DT.HPV.2 doses: 2-dose schedule @decision: IMMZ.D2.DT.HPV.Single dose: Alternative single-dose schedule */ define "Client's HIV status is positive": Encounter."Client's HIV status is positive"
/* @internal: Immunocompromised Observation */ define "Immunocompromised Observation": ([Observation: Concepts."Immunocompromised"] O sort by end of effective.toInterval() desc).complete()
/* @input: Client is immunocompromised @pseudocode: "Immunocompromised" = TRUE */ define "Client is immunocompromised": exists( "Immunocompromised Observation" ) and First( "Immunocompromised Observation" ).value = true
/* @input: Client is immunocompromised @pseudocode: "Immunocompromised" = TRUE @code: Client is immunocompromised-26 @decision: IMMZ.D2.DT.HPV.2 doses: 2-dose schedule @decision: IMMZ.D2.DT.HPV.Single dose: Alternative single-dose schedule */ define "Client is immunocompromised": Encounter."Client is immunocompromised"
Three HPV primary series doses were administered
/* @input: Three HPV primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "HPV vaccines" and "Type of dose" = "Primary series") = 3 @code: Three HPV primary series doses were administered-112 @decision: IMMZ.D2.DT.HPV.2 doses: 2-dose schedule @decision: IMMZ.D2.DT.HPV.Single dose: Alternative single-dose schedule */ define "Three HPV primary series doses were administered": "Number of HPV Primary Series Doses Administered" = 3
Third HPV dose from the primary series was administered
/* @complete: Third HPV dose from the primary series was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "HPV vaccines") = 3 */ define "Third HPV dose from the primary series was administered": Encounter."Three HPV primary series doses were administered"
HPV dose 3 (Immunocompromised or HIV-positive)
/* @output: HPV dose 3 (Immunocompromised or HIV-positive) @description: Provision of the HPV dose 3 for individuals immunocompromised or infected with HIV @trigger: Second HPV dose from the primary series was administered and client's HIV status is positive or client is immunocompromised @pseudo: Count of vaccines administered (where "Vaccine type" = "HPV vaccines") = 2 AND ("HIV status" = "HIV-positive" OR "Immunocompromised" = TRUE) @triggerDate: Latest "Date and time of vaccination" (where "Vaccine type" = "HPV vaccines") */ define "HPV dose 3 (Immunocompromised or HIV-positive)": "Second HPV dose from the primary series was administered" and ( Encounter."Client's HIV status is positive" or Encounter."Client is immunocompromised" ) and not "Third HPV dose from the primary series was administered"
/* @internal: Date of Latest HPV Dose */ define "Date of Latest HPV Dose": date from start of "HPV Doses Administered to Patient".mostRecent().occurrence.toInterval()
HPV dose 3 (Immunocompromised or HIV-positive) Due Date
/* @dynamicValue: HPV dose 3 (Immunocompromised or HIV-positive) Due Date @pseudocode: Latest "Date and time of vaccination" (where "Vaccine type" = "HPV vaccines") + 6 months */ define "HPV dose 3 (Immunocompromised or HIV-positive) Due Date": if "HPV dose 3 (Immunocompromised or HIV-positive)" then Encounter."Date of Latest HPV Dose" + 6 months else null
HPV dose 3 (Immunocompromised or HIV-positive) Create
/* @output: HPV dose 3 (Immunocompromised or HIV-positive) Create @create: Where possible, three HPV doses should be provided to individuals known to be immunocompromised or infected with HIV. */ define "HPV dose 3 (Immunocompromised or HIV-positive) Create": if "HPV dose 3 (Immunocompromised or HIV-positive)" then 'Where possible, three HPV doses should be provided to individuals known to be immunocompromised or infected with HIV.' + ' Due Date: ' + ToString("HPV dose 3 (Immunocompromised or HIV-positive) Due Date") else ''
No HPV primary series doses were administered
/* @input: No HPV primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "HPV vaccines" and "Type of dose" = "Primary series") = 0 @code: No HPV primary series doses were administered-112 @decision: IMMZ.D2.DT.HPV.2 doses: 2-dose schedule @decision: IMMZ.D2.DT.HPV.Single dose: Alternative single-dose schedule */ define "No HPV primary series doses were administered": "Number of HPV Primary Series Doses Administered" = 0
One HPV primary series dose was administered
/* @input: One HPV primary series dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "HPV vaccines" and "Type of dose" = "Primary series") = 1 @code: One HPV primary series dose was administered-112 @decision: IMMZ.D2.DT.HPV.2 doses: 2-dose schedule @decision: IMMZ.D2.DT.HPV.Single dose: Alternative single-dose schedule */ define "One HPV primary series dose was administered": "Number of HPV Primary Series Doses Administered" = 1
First HPV dose from the primary series was administered
/* @complete: First HPV dose from the primary series was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "HPV vaccines") = 1 */ define "First HPV dose from the primary series was administered": Encounter."One HPV primary series dose was administered"
/* @output: Human papillomavirus (HPV) dose 1 @description: Provision of the HPV dose 1 @trigger: Child's birth @pseudo: @triggerDate: "Date of birth" */ define "Human papillomavirus (HPV) dose 1": Encounter."No HPV primary series doses were administered" and not "First HPV dose from the primary series was administered"
Human papillomavirus (HPV) dose 1 Due Date
/* @dynamicValue: Human papillomavirus (HPV) dose 1 Due Date @pseudocode: "Date of birth" + 9 years */ define "Human papillomavirus (HPV) dose 1 Due Date": if "Human papillomavirus (HPV) dose 1" then Patient.birthDate + 9 years else null
Human papillomavirus (HPV) dose 1 Overdue
/* @dynamicValue: Human papillomavirus (HPV) dose 1 Overdue @pseudocode: "Date of birth" + 20 years */ define "Human papillomavirus (HPV) dose 1 Overdue": if "Human papillomavirus (HPV) dose 1" then Patient.birthDate + 20 years else null
Human papillomavirus (HPV) dose 1 Create
/* @output: Human papillomavirus (HPV) dose 1 Create @create: HPV dose 1 should be provided if the client is older than 9 years of age. */ define "Human papillomavirus (HPV) dose 1 Create": if "Human papillomavirus (HPV) dose 1" then 'HPV dose 1 should be provided if the client is older than 9 years of age.' + ' Due Date: ' + ToString("Human papillomavirus (HPV) dose 1 Due Date") + ' Overdue: ' + ToString("Human papillomavirus (HPV) dose 1 Overdue") else ''
HPV dose 2 (Immunocompromised or HIV-positive)
/* @output: HPV dose 2 (Immunocompromised or HIV-positive) @description: Provision of the HPV dose 2 for individuals immunocompromised or infected with HIV @trigger: First HPV dose from the primary series was administered and client's HIV status is positive or client is immunocompromised @pseudo: Count of vaccines administered (where "Vaccine type" = "HPV vaccines") = 1 AND ("HIV status" = "HIV-positive" OR "Immunocompromised" = TRUE) @triggerDate: "Date and time of vaccination" (where "Vaccine type" = "HPV vaccines") */ define "HPV dose 2 (Immunocompromised or HIV-positive)": "First HPV dose from the primary series was administered" and ( Encounter."Client's HIV status is positive" or Encounter."Client is immunocompromised" ) and not "Second HPV dose from the primary series was administered"
HPV dose 2 (Immunocompromised or HIV-positive) Due Date
/* @dynamicValue: HPV dose 2 (Immunocompromised or HIV-positive) Due Date @pseudocode: "Date and time of vaccination" (where "Vaccine type" = "HPV vaccines") + 6 months */ define "HPV dose 2 (Immunocompromised or HIV-positive) Due Date": if "HPV dose 2 (Immunocompromised or HIV-positive)" then Encounter."Date of Latest HPV Dose" + 6 months else null
HPV dose 2 (Immunocompromised or HIV-positive) Create
/* @output: HPV dose 2 (Immunocompromised or HIV-positive) Create @create: Individuals known to be immunocompromised or infected with HIV should receive at least two HPV vaccine doses. */ define "HPV dose 2 (Immunocompromised or HIV-positive) Create": if "HPV dose 2 (Immunocompromised or HIV-positive)" then 'Individuals known to be immunocompromised or infected with HIV should receive at least two HPV vaccine doses.' + ' Due Date: ' + ToString("HPV dose 2 (Immunocompromised or HIV-positive) 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 }
/** * @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)
/* @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, '/'))
define fluent function complete(observations List<Observation>): observations O where O.status in { 'final', 'amended', 'corrected' }
define function ToString(value ObservationStatus): value.value
define fluent function mostRecent(immunizations List<Immunization>): Last( immunizations I sort by start of occurrence.toInterval() )
IMMZ.D18.S.Single-dose schedule Alternative single-dose schedule
WHO recommendations for routine immunization - summary tables (January 2025)
Provision of the HPV dose 1 Trigger event: Child's birth Trigger pseudo: Trigger date: "Date of birth" Create condition: HPV dose 1 should be provided if the client is older than 9 years of age.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }
Provision of the HPV dose 2 for individuals immunocompromised or infected with HIV Trigger event: First HPV dose from the primary series was administered and client's HIV status is positive or client is immunocompromised Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "HPV vaccines") = 1 AND ("HIV status" = "HIV-positive" OR "Immunocompromised" = TRUE) Trigger date: "Date and time of vaccination" (where "Vaccine type" = "HPV vaccines") Create condition: Individuals known to be immunocompromised or infected with HIV should receive at least two HPV vaccine doses.
Provision of the HPV dose 3 for individuals immunocompromised or infected with HIV Trigger event: Second HPV dose from the primary series was administered and client's HIV status is positive or client is immunocompromised Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "HPV vaccines") = 2 AND ("HIV status" = "HIV-positive" OR "Immunocompromised" = TRUE) Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "HPV vaccines") Create condition: Where possible, three HPV doses should be provided to individuals known to be immunocompromised or infected with HIV.