Id: IMMZD2DTDTPOnTimeStart
Url: IMMZ.D2.DT.DTP.On-time start
Version: 1.0.0
Title: IMMZ.D2.DT.DTP.On-time start
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.D2.DT.DTP.On-time start DTP vaccination schedule, on-time start (at ≤ 12 months of age)
Knowledge Capability: computable
Related Artifacts:

References

  • WHO recommendations for routine immunization - summary tables (January 2025)
Libraries:
IMMZD2DTDTPOnTimeStartLogic
Actions:
Determine if the client is due for DTP.: Determine if the client is due for DTP vaccine according to the national immunization protocol. DTP vaccination schedule, on-time start (at ≤ 12 months of age)
If: Applicability: Client is due for DTP vaccination (Client is due for DTP vaccination)
Then: Definition: IMMZD2DTMR
Dynamic Values:
status: ('draft')
intent: ('proposal')
medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE24', display: 'DTP-containing vaccines' } }, display: 'DTP-containing vaccines' })
Determine if the client is due for DTP.: Determine if the client is due for DTP vaccine according to the national immunization protocol. DTP vaccination schedule, on-time start (at ≤ 12 months of age)
If: Applicability: Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose (Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose)
Then: Definition: IMMZD2DTMR
Dynamic Values:
status: ('draft')
intent: ('proposal')
medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE28', display: 'Tetanus and diphtheria-containing vaccines' } }, display: 'Tetanus and diphtheria-containing vaccines' })
Determine if the client is due for DTP.: Determine if the client is due for DTP vaccine according to the national immunization protocol. DTP vaccination schedule, on-time start (at ≤ 12 months of age)
If: Applicability: Client is due for tetanus and diphtheria booster dose (Client is due for tetanus and diphtheria booster dose)
Then: Definition: IMMZD2DTMR
Dynamic Values:
status: ('draft')
intent: ('proposal')
medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE28', display: 'Tetanus and diphtheria-containing vaccines' } }, display: 'Tetanus and diphtheria-containing vaccines' })
Determine if the client is due for DTP.: Determine if the client is due for DTP vaccine according to the national immunization protocol. DTP vaccination schedule, on-time start (at ≤ 12 months of age)
If: Applicability: Primary DTP series is complete. Client is due for pertussis booster dose (Primary DTP series is complete. Client is due for pertussis booster dose)
Then: Definition: IMMZD2DTMR
Dynamic Values:
status: ('draft')
intent: ('proposal')
medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE12', display: 'Pertussis-containing vaccines' } }, display: 'Pertussis-containing vaccines' })
Check for Guidance for the patient regarding IMMZ.D2.DT.DTP.On-time start.: Show Guidance for the patient regarding IMMZ.D2.DT.DTP.On-time start.
If: Applicability: Has Guidance (Has Guidance)
Then: Definition: IMMZ.D2.DT.CR
Dynamic Values:
status: ('active')
payload.contentString: (Guidance)
category.coding: (Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })
priority: (Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })
<type> <coding> <system value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/> <code value="eca-rule"/> </coding> </type> <status value="draft"/> <experimental value="false"/> <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="IMMZ.D2.DT.DTP.On-time start DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/> <relatedArtifact> <type value="citation"/> <citation value="WHO recommendations for routine immunization - summary tables (January 2025)"/> </relatedArtifact> <library value="http://smart.who.int/immunizations/Library/IMMZD2DTDTPOnTimeStartLogic"/> <action> <extension url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale"> <valueMarkdown value="A primary series of 3 doses of DTP-containing vaccine is recommended, with the first dose administered as early as 6 weeks of age. Subsequent doses should be given with an interval of at least 4 weeks between doses."/> </extension> <title value="Determine if the client is due for DTP."/> <description value="Determine if the client is due for DTP vaccine according to the national immunization protocol. DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/> <condition> <kind value="applicability"/> <expression> <description value="Client is due for DTP vaccination"/> <language value="text/cql-identifier"/> <expression value="Client is due for DTP vaccination"/> </expression> </condition> <definitionCanonical value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTMR"/> <dynamicValue> <path value="status"/> <expression> <language value="text/cql-expression"/> <expression value="'draft'"/> </expression> </dynamicValue> <dynamicValue> <path value="intent"/> <expression> <language value="text/cql-expression"/> <expression value="'proposal'"/> </expression> </dynamicValue> <dynamicValue> <path value="medication"/> <expression> <language value="text/cql-expression"/> <expression value="Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE24', display: 'DTP-containing vaccines' } }, display: 'DTP-containing vaccines' }"/> </expression> </dynamicValue> </action> <action> <extension url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale"> <valueMarkdown value="Three booster doses of diphtheria toxoid-containing vaccine should be provided during childhood and adolescence. The diphtheria booster doses should be given in combination with tetanus toxoid using the same schedule (i.e at 12–23 months of age, 4–7 years of age and 9–15 years of age, using age-appropriate vaccine formulations). Ideally, there should be at least 4 years between booster doses. Member States may update this schedule based on their country context. For children aged under 7 years, diphtheria and tetanus toxoids and whole-cell pertussis (DTwP) vaccine or diphtheria and tetanus toxoids and acellular pertussis (DTaP) combinations may be used. For children aged 4 years and older, tetanus toxoid, reduced diphtheria toxoid (Td)-containing vaccine may be used and is preferred. From 7 years of age, only Td combinations should be used. Age-appropriate combinations-containing pertussis vaccine with low-dose diphtheria antigen are also available. Only aP-containing vaccines should be used for vaccination of persons aged 7 years and older. National vaccination schedules can be adjusted within the age limits specified above to enable programmes to tailor their schedules based on local epidemiology, the objectives of the immunization programme, any particular programmatic issues and to better align tetanus vaccination with the immunological requirements of other vaccines (particularly for pertussis and diphtheria)."/> </extension> <title value="Determine if the client is due for DTP."/> <description value="Determine if the client is due for DTP vaccine according to the national immunization protocol. DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/> <condition> <kind value="applicability"/> <expression> <description value="Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose"/> <language value="text/cql-identifier"/> <expression value="Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose"/> </expression> </condition> <definitionCanonical value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTMR"/> <dynamicValue> <path value="status"/> <expression> <language value="text/cql-expression"/> <expression value="'draft'"/> </expression> </dynamicValue> <dynamicValue> <path value="intent"/> <expression> <language value="text/cql-expression"/> <expression value="'proposal'"/> </expression> </dynamicValue> <dynamicValue> <path value="medication"/> <expression> <language value="text/cql-expression"/> <expression value="Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE28', display: 'Tetanus and diphtheria-containing vaccines' } }, display: 'Tetanus and diphtheria-containing vaccines' }"/> </expression> </dynamicValue> </action> <action> <extension url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale"> <valueMarkdown value="Three booster doses of diphtheria toxoid-containing vaccine should be provided during childhood and adolescence. The diphtheria booster doses should be given in combination with tetanus toxoid using the same schedule (i.e at 12–23 months of age, 4–7 years of age and 9–15 years of age, using age-appropriate vaccine formulations). Ideally, there should be at least 4 years between booster doses. Member States may update this schedule based on their country context. For children aged under 7 years, diphtheria and tetanus toxoids and whole-cell pertussis (DTwP) vaccine or diphtheria and tetanus toxoids and acellular pertussis (DTaP) combinations may be used. For children aged 4 years and older, tetanus toxoid, reduced diphtheria toxoid (Td)-containing vaccine may be used and is preferred. From 7 years of age, only Td combinations should be used. Age-appropriate combinations-containing pertussis vaccine with low-dose diphtheria antigen are also available. Only aP-containing vaccines should be used for vaccination of persons aged 7 years and older. National vaccination schedules can be adjusted within the age limits specified above to enable programmes to tailor their schedules based on local epidemiology, the objectives of the immunization programme, any particular programmatic issues and to better align tetanus vaccination with the immunological requirements of other vaccines (particularly for pertussis and diphtheria)."/> </extension> <title value="Determine if the client is due for DTP."/> <description value="Determine if the client is due for DTP vaccine according to the national immunization protocol. DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/> <condition> <kind value="applicability"/> <expression> <description value="Client is due for tetanus and diphtheria booster dose"/> <language value="text/cql-identifier"/> <expression value="Client is due for tetanus and diphtheria booster dose"/> </expression> </condition> <definitionCanonical value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTMR"/> <dynamicValue> <path value="status"/> <expression> <language value="text/cql-expression"/> <expression value="'draft'"/> </expression> </dynamicValue> <dynamicValue> <path value="intent"/> <expression> <language value="text/cql-expression"/> <expression value="'proposal'"/> </expression> </dynamicValue> <dynamicValue> <path value="medication"/> <expression> <language value="text/cql-expression"/> <expression value="Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE28', display: 'Tetanus and diphtheria-containing vaccines' } }, display: 'Tetanus and diphtheria-containing vaccines' }"/> </expression> </dynamicValue> </action> <action> <extension url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale"> <valueMarkdown value="A pertussis booster dose is recommended for children aged 1–6 years, preferably during the second year of life (≥ 6 months after last primary dose), unless otherwise indicated by local epidemiology; the contact could also be used to catch up on any missed doses of other vaccines. This schedule should provide protection for at least 6 years for countries using wP-containing vaccine. For countries using aP-containing vaccine, protection may decline appreciably before 6 years of age. Only aP-containing vaccines should be used for vaccination of persons aged 7 years and over. Although a booster dose in adolescence has been shown to decrease disease in adolescents, this is not generally recommended as a means of controlling pertussis in infants."/> </extension> <title value="Determine if the client is due for DTP."/> <description value="Determine if the client is due for DTP vaccine according to the national immunization protocol. DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/> <condition> <kind value="applicability"/> <expression> <description value="Primary DTP series is complete. Client is due for pertussis booster dose"/> <language value="text/cql-identifier"/> <expression value="Primary DTP series is complete. Client is due for pertussis booster dose"/> </expression> </condition> <definitionCanonical value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTMR"/> <dynamicValue> <path value="status"/> <expression> <language value="text/cql-expression"/> <expression value="'draft'"/> </expression> </dynamicValue> <dynamicValue> <path value="intent"/> <expression> <language value="text/cql-expression"/> <expression value="'proposal'"/> </expression> </dynamicValue> <dynamicValue> <path value="medication"/> <expression> <language value="text/cql-expression"/> <expression value="Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE12', display: 'Pertussis-containing vaccines' } }, display: 'Pertussis-containing vaccines' }"/> </expression> </dynamicValue> </action> <action> <title value="Check for Guidance for the patient regarding IMMZ.D2.DT.DTP.On-time start."/> <description value="Show Guidance for the patient regarding IMMZ.D2.DT.DTP.On-time start."/> <condition> <kind value="applicability"/> <expression> <description value="Has Guidance"/> <language value="text/cql-identifier"/> <expression value="Has Guidance"/> </expression> </condition> <definitionCanonical value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTCR"/> <dynamicValue> <path value="status"/> <expression> <language value="text/cql-expression"/> <expression value="'active'"/> </expression> </dynamicValue> <dynamicValue> <path value="payload.contentString"/> <expression> <language value="text/cql-identifier"/> <expression value="Guidance"/> </expression> </dynamicValue> <dynamicValue> <path value="category.coding"/> <expression> <description value="Category of communication"/> <language value="text/cql-expression"/> <expression value="Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }"/> </expression> </dynamicValue> <dynamicValue> <path value="priority"/> <expression> <description value="Alert priority"/> <language value="text/cql-expression"/> <expression value="Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }"/> </expression> </dynamicValue> </action> </PlanDefinition>