<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.Pregnancy starting with 4 doses Diphtheria and tetanus vaccination schedule in pregnant women who received 4 childhood DTP doses"/> <relatedArtifact> <type value="citation"/> <citation value="WHO recommendations for routine immunization - summary tables (January 2025)"/> </relatedArtifact> <library value="http://smart.who.int/immunizations/Library/IMMZD2DTDTPPregnancyStartingWith4DosesLogic"/> <action> <extension url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale"> <valueMarkdown value="Pregnant women who received 4 tetanus-containing vaccines doses during childhood or pre-adulthood need only 1 booster dose, which should be given at the first opportunity. To provide lifelong protection, a sixth dose would be needed at least 1 year after the fifth dose, or during the next pregnancy. From 7 years of age, only tetanus toxoid with reduced diphtheria toxoid (Td) combinations should be used. Age-appropriate combinations-containing pertussis vaccine with reduced diphtheria toxoid are also available. Only acellular pertussis (aP)-containing vaccines should be used for vaccination of persons aged 7 years and older."/> </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. Diphtheria and tetanus vaccination schedule in pregnant women who received 4 childhood DTP doses"/> <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> <title value="Check for Guidance for the patient regarding IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses."/> <description value="Show Guidance for the patient regarding IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses."/> <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>

Id:

IMMZD2DTDTPPregnancyStartingWith4Doses

Url:

IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses

Version:

1.0.0

Title:

IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses

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.Pregnancy starting with 4 doses Diphtheria and tetanus vaccination schedule in pregnant women who received 4 childhood DTP doses

Knowledge Capability:

computable

Related Artifacts:

References

WHO recommendations for routine immunization - summary tables (January 2025)

Libraries:

IMMZD2DTDTPPregnancyStartingWith4DosesLogic

Actions:

Determine if the client is due for DTP.: Determine if the client is due for DTP vaccine according to the national immunization protocol. Diphtheria and tetanus vaccination schedule in pregnant women who received 4 childhood DTP doses
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' })

Check for Guidance for the patient regarding IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses.: Show Guidance for the patient regarding IMMZ.D2.DT.DTP.Pregnancy starting with 4 doses.
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' })