Id: IMMZD2DTDengue3DosesWithoutPreVaccinationScreening Url: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening Version: 1.0.0 Title: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening 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.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] Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic Actions: Determine if the client is due for Dengue.: Determine if the client is due for Dengue vaccine according to the national immunization protocol. 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] If: Applicability: Client is due for dengue vaccination (Client is due for dengue vaccination) Then: Definition: IMMZD2DTMR Dynamic Values: status: ('draft') intent: ('proposal') medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE25', display: 'Dengue vaccines' } }, display: 'Dengue vaccines' }) Check for Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening.: Show Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening. 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' })
/** * @dataElement Patient age in years */ define "Current Patient Age In Years": AgeInYearsAt(Today)
/* @input: Client's age is less than 9 years @pseudocode: Today's date − "Date of birth" < 9 years @code: Client's age is less than 9 years-40 @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 less than 9 years": Encounter."Current Patient Age In Years" < 9
Client is not due for dengue vaccination Case 1
/* @output: Client is not due for dengue vaccination Case 1 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination Case 1": Encounter."Client's age is less than 9 years"
/* @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
Client is not due for dengue vaccination Case 2
/* @output: Client is not due for dengue vaccination Case 2 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination Case 2": Encounter."Client's age is more than 45 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
Client's age is between 9 years and 45 years
/* @input: Client's age is between 9 years and 45 years @pseudocode: 9 years ≤ Today's date − "Date of birth" ≤ 45 years @code: Client's age is between 9 years and 45 years-51 @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 between 9 years and 45 years": Encounter."Current Patient Age In Years" >= 9 and Encounter."Current Patient Age In Years" <= 45
/* @internal: Date of Latest Dengue Dose */ define "Date of Latest Dengue Dose": date from start of "Dengue Doses Administered to Patient".mostRecent().occurrence.toInterval()
The latest dengue dose was administered less than 6 months ago
/* @input: The latest dengue dose was administered less than 6 months ago @pseudocode: Today's date - Latest "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") < 6 months @code: The latest dengue dose was administered less than 6 months ago-106 @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 "The latest dengue dose was administered less than 6 months ago": "Date of Latest Dengue Dose" is not null and duration in months between "Date of Latest Dengue Dose" and Today < 6
Client is not due for dengue vaccination Case 3
/* @output: Client is not due for dengue vaccination Case 3 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination Case 3": Encounter."One dengue primary series dose was administered" and Encounter."Client's age is between 9 years and 45 years" and Encounter."The latest dengue dose was administered less than 6 months ago"
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
Client is not due for dengue vaccination Case 4
/* @output: Client is not due for dengue vaccination Case 4 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination Case 4": Encounter."Two dengue primary series doses were administered" and Encounter."Client's age is between 9 years and 45 years" and Encounter."The latest dengue dose was administered less than 6 months ago"
Client is not due for dengue vaccination
/* @output: Client is not due for dengue vaccination @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for dengue vaccination": "Client is not due for dengue vaccination Case 1" or "Client is not due for dengue vaccination Case 2" or "Client is not due for dengue vaccination Case 3" or "Client is not due for dengue vaccination Case 4"
Client is not due for dengue vaccination Guidance
/* @output: Client is not due for dengue vaccination Guidance @guidance = Should not vaccinate client with first dengue dose as client's age is less than 9 years. Check for any other vaccines due and inform the caregiver of when to come back for first dose. @guidance = Should not vaccinate client with first dengue dose as client's age is more than 45 years. Check for any vaccines due. @guidance = Should not vaccinate client with second dengue dose as latest dengue dose was administered less than 6 months ago. Check for any other vaccines due and inform the caregiver of when to come back for the second dose. @guidance = Should not vaccinate client with third dengue dose as latest dengue vaccine was administered less than 6 months ago. Check for any other vaccines due and inform the caregiver of when to come back for the third dose. */ define "Client is not due for dengue vaccination Guidance": case when "Client is not due for dengue vaccination Case 1" then 'Should not vaccinate client with first dengue dose as client\'s age is less than 9 years. Check for any other vaccines due and inform the caregiver of when to come back for first dose.' when "Client is not due for dengue vaccination Case 2" then 'Should not vaccinate client with first dengue dose as client\'s age is more than 45 years. Check for any vaccines due.' when "Client is not due for dengue vaccination Case 3" then 'Should not vaccinate client with second dengue dose as latest dengue dose was administered less than 6 months ago. Check for any other vaccines due and inform the caregiver of when to come back for the second dose.' when "Client is not due for dengue vaccination Case 4" then 'Should not vaccinate client with third dengue dose as latest dengue vaccine was administered less than 6 months ago. Check for any other vaccines due and inform the caregiver of when to come back for the third dose.' else '' end
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
Client is due for dengue vaccination Case 1
/* @output: Client is due for dengue vaccination Case 1 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for dengue vaccination Case 1": Encounter."No dengue primary series doses were administered" and Encounter."Client's age is between 9 years and 45 years"
The latest dengue dose was administered more than 6 months ago
/* @input: The latest dengue dose was administered more than 6 months ago @pseudocode: Today's date - Latest "Date and time of vaccination" (where "Vaccine type" = "Dengue vaccines") ≥ 6 months @code: The latest dengue dose was administered more than 6 months ago-106 @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 "The latest dengue dose was administered more than 6 months ago": "Date of Latest Dengue Dose" is not null and duration in months between "Date of Latest Dengue Dose" and Today >= 6
Client is due for dengue vaccination Case 2
/* @output: Client is due for dengue vaccination Case 2 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for dengue vaccination Case 2": Encounter."One dengue primary series dose was administered" and Encounter."Client's age is between 9 years and 45 years" and Encounter."The latest dengue dose was administered more than 6 months ago"
Client is due for dengue vaccination Case 3
/* @output: Client is due for dengue vaccination Case 3 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for dengue vaccination Case 3": Encounter."Two dengue primary series doses were administered" and Encounter."Client's age is between 9 years and 45 years" and Encounter."The latest dengue dose was administered more than 6 months ago"
/* @output: Client is due for dengue vaccination @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for dengue vaccination": "Client is due for dengue vaccination Case 1" or "Client is due for dengue vaccination Case 2" or "Client is due for dengue vaccination Case 3"
Client is due for dengue vaccination Guidance
/* @output: Client is due for dengue vaccination Guidance @guidance = Should vaccinate client with first dengue dose as no dengue doses were administered and client is within appropriate age range. Check for contraindications. @guidance = Should vaccinate client with second dengue dose as latest dengue dose was administered more than 6 months ago. Check for contraindications. @guidance = Should vaccinate client with third dengue dose as latest dengue dose was administered more than 6 months ago. Check for contraindications. */ define "Client is due for dengue vaccination Guidance": case when "Client is due for dengue vaccination Case 1" then 'Should vaccinate client with first dengue dose as no dengue doses were administered and client is within appropriate age range. Check for contraindications.' when "Client is due for dengue vaccination Case 2" then 'Should vaccinate client with second dengue dose as latest dengue dose was administered more than 6 months ago. Check for contraindications.' when "Client is due for dengue vaccination Case 3" then 'Should vaccinate client with third dengue dose as latest dengue dose was administered more than 6 months ago. Check for contraindications.' else '' end
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
Dengue immunization schedule is complete
/* @output: Dengue immunization schedule is complete @pseudocode: "Immunization recommendation status" = "Complete" "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Dengue vaccines")" */ define "Dengue immunization schedule is complete": Encounter."Three dengue primary series doses were administered" and Encounter."Client's age is between 9 years and 45 years"
Dengue immunization schedule is complete Guidance
/* @output: Dengue immunization schedule is complete Guidance @guidance: Dengue immunization schedule is complete. Three dengue primary series doses were administered. Check for any other vaccines due. */ define "Dengue immunization schedule is complete Guidance": 'Dengue immunization schedule is complete. Three dengue primary series doses were administered. Check for any other vaccines due.'
/* @dynamicValue: Guidance */ define "Guidance": case when "Client is not due for dengue vaccination" then "Client is not due for dengue vaccination Guidance" when "Client is due for dengue vaccination" then "Client is due for dengue vaccination Guidance" when "Dengue immunization schedule is complete" then "Dengue immunization schedule is complete Guidance" else '' end
define "Has Guidance": "Guidance" is not null and "Guidance" != ''
/** * @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 }
define fluent function mostRecent(immunizations List<Immunization>): Last( immunizations I sort by start of occurrence.toInterval() )
IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening
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]
WHO recommendations for routine immunization - summary tables (January 2025)
Currently, the dengue vaccine should be used within the indicated age range, which in most countries is 9–45 years. If pre-vaccination screening is not feasible, vaccination without individual screening could be considered in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years. Communication needs to ensure appropriate and full disclosure of the risks of vaccination of persons with unknown serostatus. CYD-TDV is recommended as a 3-dose series given 6 months apart. Should a vaccine dose be delayed for any reason, it is not necessary to restart the course and the next dose in the series should be administered as soon as possible.
Determine if the client is due for Dengue.
Determine if the client is due for Dengue vaccine according to the national immunization protocol. 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]
Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE25', display: 'Dengue vaccines' } }, display: 'Dengue vaccines' }
Check for Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening.
Show Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }