Id: IMMZD18SHepatitisB4Doses Url: IMMZ.D18.S.Hepatitis B.4-dose schedule Version: 1.0.0 Title: IMMZ.D18.S.Hepatitis B.4-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.Hepatitis B.4-dose schedule 4-dose schedule (birth dose + 3 primary series doses), on-time start Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD18SHepatitisB4DosesLogic Actions: Hepatitis B dose 1: Provision of hepatitis B dose 1 Trigger event: Child's birth Trigger pseudo: Trigger date: "Date of birth" Create condition: The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks. If: Applicability: Hepatitis B dose 1 (Hepatitis B dose 1) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Hepatitis B 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' }) Hepatitis B dose 2: Provision of hepatitis B dose 2 Trigger event: First hepatitis B dose from the primary series was administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose"= "Primary series") = 1 Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") Create condition: The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks. If: Applicability: Hepatitis B dose 2 (Hepatitis B dose 2) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Hepatitis B 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' }) Hepatitis B dose 3: Provision of hepatitis B dose 3 Trigger event: Second hepatitis B dose from the primary series was administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose"= "Primary series") = 2 Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") Create condition: The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks. If: Applicability: Hepatitis B dose 3 (Hepatitis B dose 3) Then: Definition: IMMZ.D2.DT.CR Dynamic Values: status: ('active') payload.contentString: (Hepatitis B 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' })
/** * @dataElement All Doses Administered to Patient */ define "Doses Administered to Patient": [Immunization] I where I.status = 'completed' and I.isSubpotent is not true
Hepatitis B Doses Administered to Patient
/* @internal: Hepatitis B containing Doses Administered to Patient */ define "Hepatitis B Doses Administered to Patient": Elements."Doses Administered to Patient" I where I.vaccineCode in Concepts."Hepatitis B-containing vaccines"
Hepatitis B Primary Series Doses Administered to Patient
/* @internal: Hepatitis B containing Doses Administered to Patient that are in the Primary series */ define "Hepatitis B Primary Series Doses Administered to Patient": "Hepatitis B Doses Administered to Patient".seriesPrimary()
/* @internal: Hepatitis B containing Doses Administered to Patient that are in the Primary series */ define "Hepatitis B Primary Series Doses Administered to Patient": HepatitisBElements."Hepatitis B Primary Series Doses Administered to Patient".onOrBefore(Today)
Number of Hepatitis B Primary Series Doses Administered
/* @internal: Number of Hepatitis B Primary Series doses */ define "Number of Hepatitis B Primary Series Doses Administered": Count("Hepatitis B Primary Series Doses Administered to Patient")
One hepatitis B primary series dose was administered
/* @input: One hepatitis B primary series dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose" = "Primary series") = 1 @code: One hepatitis B primary series dose was administered-131 @decision: IMMZ.D2.DT.Hepatitis B.3 doses: 3-dose schedule (birth dose + 2 primary series doses), on-time start */ define "One hepatitis B primary series dose was administered": "Number of Hepatitis B Primary Series Doses Administered" = 1
First hepatitis B dose from the primary series was administered
/* @complete: First hepatitis B dose from the primary series was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose"= "Primary series") = 1 */ define "First hepatitis B dose from the primary series was administered": Encounter."One hepatitis B primary series dose was administered"
Two hepatitis B primary series doses were administered
/* @input: Two hepatitis B primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose" = "Primary series") = 2 @code: Two hepatitis B primary series doses were administered-131 @decision: IMMZ.D2.DT.Hepatitis B.3 doses: 3-dose schedule (birth dose + 2 primary series doses), on-time start @decision: IMMZ.D2.DT.Hepatitis B.4 doses: 4-dose schedule (birth dose + 3 primary series doses), on-time start */ define "Two hepatitis B primary series doses were administered": "Number of Hepatitis B Primary Series Doses Administered" = 2
Second hepatitis B dose from the primary series was administered
/* @complete: Second hepatitis B dose from the primary series was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose"= "Primary series") = 2 */ define "Second hepatitis B dose from the primary series was administered": Encounter."Two hepatitis B primary series doses were administered"
Three hepatitis B primary series doses were administered
/* @input: Three hepatitis B primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose" = "Primary series") = 3 @code: Three hepatitis B primary series doses were administered-131 @decision: IMMZ.D2.DT.Hepatitis B.3 doses: 3-dose schedule (birth dose + 2 primary series doses), on-time start @decision: IMMZ.D2.DT.Hepatitis B.4 doses: 4-dose schedule (birth dose + 3 primary series doses), on-time start */ define "Three hepatitis B primary series doses were administered": "Number of Hepatitis B Primary Series Doses Administered" = 3
Third hepatitis B dose from the primary series was administered. The primary series has been completed
/* @complete: Third hepatitis B dose from the primary series was administered. The primary series has been completed @pseudocode: "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Hepatitis B-containing vaccines") */ define "Third hepatitis B dose from the primary series was administered. The primary series has been completed": Encounter."Three hepatitis B primary series doses were administered"
/* @output: Hepatitis B dose 1 @description: Provision of hepatitis B dose 1 @trigger: Child's birth @pseudo: @triggerDate: "Date of birth" */ define "Hepatitis B dose 1": not "First hepatitis B dose from the primary series was administered" and not "Second hepatitis B dose from the primary series was administered" and not "Third hepatitis B dose from the primary series was administered. The primary series has been completed"
/* @output: Hepatitis B dose 3 @description: Provision of hepatitis B dose 3 @trigger: Second hepatitis B dose from the primary series was administered @pseudo: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose"= "Primary series") = 2 @triggerDate: Latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") */ define "Hepatitis B dose 3": "Second hepatitis B dose from the primary series was administered" and not "Third hepatitis B dose from the primary series was administered. The primary series has been completed"
/* @output: Hepatitis B dose 2 @description: Provision of hepatitis B dose 2 @trigger: First hepatitis B dose from the primary series was administered @pseudo: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose"= "Primary series") = 1 @triggerDate: Latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") */ define "Hepatitis B dose 2": "First hepatitis B dose from the primary series was administered" and not "Second hepatitis B dose from the primary series was administered" and not "Third hepatitis B dose from the primary series was administered. The primary series has been completed"
/* @internal: Hepatitis B containing Doses Administered to Patient */ define "Hepatitis B Doses Administered to Patient": HepatitisBElements."Hepatitis B Doses Administered to Patient".onOrBefore(Today)
/* @internal: Date of Latest Hepatitis B Dose */ define "Date of Latest Hepatitis B Dose": date from start of "Hepatitis B Doses Administered to Patient".mostRecent().occurrence.toInterval()
/* @dynamicValue: Hepatitis B dose 2 Due Date @pseudocode: Latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") + 4 weeks */ define "Hepatitis B dose 2 Due Date": if "Hepatitis B dose 2" then Encounter."Date of Latest Hepatitis B Dose" + 4 weeks else null
/* @output: Hepatitis B dose 2 Create @create: The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks. */ define "Hepatitis B dose 2 Create": if "Hepatitis B dose 2" then 'The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks.' + ' Due Date: ' + ToString("Hepatitis B dose 2 Due Date") else ''
/* @dynamicValue: Hepatitis B dose 1 Due Date @pseudocode: "Date of birth" + Member States defined lower limit */ define "Hepatitis B dose 1 Due Date": if "Hepatitis B dose 1" then Patient.birthDate + (Encounter.HepBLowerLimitWeeks * 1 weeks) else null
/* @output: Hepatitis B dose 1 Create @create: The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks. */ define "Hepatitis B dose 1 Create": if "Hepatitis B dose 1" then 'The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks.' + ' Due Date: ' + ToString("Hepatitis B dose 1 Due Date") else ''
/* @dynamicValue: Hepatitis B dose 3 Due Date @pseudocode: Latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") + 4 weeks */ define "Hepatitis B dose 3 Due Date": if "Hepatitis B dose 3" then Encounter."Date of Latest Hepatitis B Dose" + 4 weeks else null
/* @output: Hepatitis B dose 3 Create @create: The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks. */ define "Hepatitis B dose 3 Create": if "Hepatitis B dose 3" then 'The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks.' + ' Due Date: ' + ToString("Hepatitis B dose 3 Due Date") else ''
/** * @description: Gets immunizations on or before a date */ define fluent function onOrBefore(immunizations List<Immunization>, beforeDate Date): immunizations I where I.occurrence.toInterval() same day or before beforeDate
/* 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
/** * @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
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() )
Value set Hepatitis B-containing vaccines
IMMZ.D18.S.Hepatitis B.4-dose schedule 4-dose schedule (birth dose + 3 primary series doses), on-time start
WHO recommendations for routine immunization - summary tables (January 2025)
Provision of hepatitis B dose 1 Trigger event: Child's birth Trigger pseudo: Trigger date: "Date of birth" Create condition: The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }
Provision of hepatitis B dose 2 Trigger event: First hepatitis B dose from the primary series was administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose"= "Primary series") = 1 Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") Create condition: The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks.
Provision of hepatitis B dose 3 Trigger event: Second hepatitis B dose from the primary series was administered Trigger pseudo: Count of vaccines administered (where "Vaccine type" = "Hepatitis B-containing vaccines" and "Type of dose"= "Primary series") = 2 Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Hepatitis B-containing vaccines") Create condition: The following option is considered appropriate: 4 doses, where a monovalent birth dose is followed by 3 (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm. The interval between doses should be at least 4 weeks.