WHO Immunization Implementation Guide
1.0.0 - release

WHO Immunization Implementation Guide, published by WHO. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-immunizations/tree/132/merge and changes regularly. See the Directory of published versions

: IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening - XML Representation

Draft as of 2026-03-31

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<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreening"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"/>
    <profile
             value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareableplandefinition"/>
    <profile
             value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishableplandefinition"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
<div>
    <table class="grid dict">
        
        <tr>
            <th scope="row"><b>Id: </b></th>
            <td style="padding-left: 4px;">IMMZD2DTDengue3DosesWithoutPreVaccinationScreening</td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Url: </b></th>
            <td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD2DTDengue3DosesWithoutPreVaccinationScreening.html">IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening</a></td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Version: </b></th>
            <td style="padding-left: 4px;">1.0.0</td>
        </tr>
        

        

        
        <tr>
            <th scope="row"><b>Title: </b></th>
            <td style="padding-left: 4px;">IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening</td>
        </tr>
        

        

        
        <tr>
            <th scope="row"><b>Status: </b></th>
            <td style="padding-left: 4px;">draft</td>
        </tr>
        

        

        
        <tr>
            <th scope="row"><b>Type: </b></th>
            <td style="padding-left: 4px;">
                
                    
                        
                        <p style="margin-bottom: 5px;">
                            <b>system: </b> <span><a href="http://terminology.hl7.org/7.1.0/CodeSystem-plan-definition-type.html">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>
                        </p>
                        
                        
                        <p style="margin-bottom: 5px;">
                            <b>code: </b> <span>eca-rule</span>
                        </p>
                        
                        
                    
                
                
            </td>
        </tr>
        

        

        
        <tr>
            <th scope="row"><b>Date: </b></th>
            <td style="padding-left: 4px;">2026-03-31 13:54:17+0000</td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Publisher: </b></th>
            <td style="padding-left: 4px;">WHO</td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Description: </b></th>
            <td style="padding-left: 4px;"><div><p>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]</p>
</div></td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Knowledge Capability: </b></th>
            <td style="padding-left: 4px;">
                
                computable 
            </td>
        </tr>
        

        

        

        

        

        

        

        

        

        

        
        <tr>
            <th scope="row"><b>Related Artifacts: </b></th>
            <td style="padding-left: 4px;">
                
                
                <p><b>References</b></p>
                <ul>
                    
                    <li><div><p>WHO recommendations for routine immunization - summary tables (January 2025)</p>
</div><br/><a href="null"/></li>
                    
                </ul>
                
                
                
                
                
                
            </td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Libraries: </b></th>
            <td style="padding-left: 4px;">
                <table class="grid-dict">
                    
                    <tr>
                        <td><a href="Library-IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic.html">IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic</a></td>
                    </tr>
                    
                </table>
            </td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Actions: </b></th>
            <td style="padding-left: 4px;">
                <table class="grid-dict">
                    
                    <tr>
                        <td>
                            
                            <b> Determine if the client is due for Dengue.:</b> 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]
                            
                            <br/>
                            
                            
                            <b>If:</b>
                            
                            <i>Applicability:</i>
                            
                            Client is due for dengue vaccination
                            
                            <i>(Client is due for dengue vaccination)</i>
                            <br/>
                            
                            
                            
                            
                            <b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTMR.html">IMMZD2DTMR</a><br/>
                            
                            <i>Dynamic Values:</i><br/>
                            
                            status: <i>('draft')</i>
                            <br/>
                            
                            intent: <i>('proposal')</i>
                            <br/>
                            
                            medication: <i>(Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE25', display: 'Dengue vaccines' } }, display: 'Dengue vaccines' })</i>
                            <br/>
                            
                            
                            
                            
                        </td>
                    </tr>
                    
                    <tr>
                        <td>
                            
                            <b> Check for Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening.:</b> Show Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening.
                            
                            <br/>
                            
                            
                            <b>If:</b>
                            
                            <i>Applicability:</i>
                            
                            Has Guidance
                            
                            <i>(Has Guidance)</i>
                            <br/>
                            
                            
                            
                            
                            <b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTCR.html">IMMZ.D2.DT.CR</a><br/>
                            
                            <i>Dynamic Values:</i><br/>
                            
                            status: <i>('active')</i>
                            <br/>
                            
                            payload.contentString: <i>(Guidance)</i>
                            <br/>
                            
                            category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>
                            <br/>
                            
                            priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>
                            <br/>
                            
                            
                            
                            
                        </td>
                    </tr>
                    
                </table>
            </td>
        </tr>
        
    </table>
</div>
</div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements"/>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString value="Current Patient Age In Years"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/** 
 * @dataElement Patient age in years
 */
define &quot;Current Patient Age In Years&quot;:
  AgeInYearsAt(Today)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString value="Client's age is less than 9 years"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@input: Client's age is less than 9 years
@pseudocode: Today's date − &quot;Date of birth&quot; &lt; 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 &quot;Client's age is less than 9 years&quot;:
  Encounter.&quot;Current Patient Age In Years&quot; &lt; 9"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Client is not due for dengue vaccination Case 1"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Client is not due for dengue vaccination Case 1
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for dengue vaccination Case 1&quot;:
  Encounter.&quot;Client's age is less than 9 years&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString value="Client's age is more than 45 years"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@input: Client's age is more than 45 years
@pseudocode: Today's date − &quot;Date of birth&quot; &gt; 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 &quot;Client's age is more than 45 years&quot;:
  Encounter.&quot;Current Patient Age In Years&quot; &gt; 45"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Client is not due for dengue vaccination Case 2"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Client is not due for dengue vaccination Case 2
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for dengue vaccination Case 2&quot;:
  Encounter.&quot;Client's age is more than 45 years&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZElements"/>
        </extension>
        <extension url="name">
          <valueString value="Doses Administered to Patient"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/**
 * @dataElement All Doses Administered to Patient
 */
define &quot;Doses Administered to Patient&quot;:
  [Immunization] I
    where I.status = 'completed'
    and I.isSubpotent is not true"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString value="Doses Administered to Patient"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/**
 * @dataElement All Doses Administered to Patient
 */
define &quot;Doses Administered to Patient&quot;:
  Elements.&quot;Doses Administered to Patient&quot; I
    where I.occurrence.toInterval() same day or before Today"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString value="Dengue Doses Administered to Patient"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@internal: Dengue containing Doses Administered to Patient
*/
define &quot;Dengue Doses Administered to Patient&quot;:
  Encounter.&quot;Doses Administered to Patient&quot; I
  where
    I.vaccineCode in Concepts.&quot;Dengue vaccines&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Dengue Primary Series Doses Administered to Patient"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@internal: Dengue containing Doses Administered to Patient that are in the Primary series
*/
define &quot;Dengue Primary Series Doses Administered to Patient&quot;:
  &quot;Dengue Doses Administered to Patient&quot;.seriesPrimary()"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Number of Dengue Primary Series Doses Administered"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@internal: Number of Dengue Primary Series doses
*/
define &quot;Number of Dengue Primary Series Doses Administered&quot;:
  Count(&quot;Dengue Primary Series Doses Administered to Patient&quot;)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="9"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString
                       value="One dengue primary series dose was administered"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@input: One dengue primary series dose was administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Dengue vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 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 &quot;One dengue primary series dose was administered&quot;:
  &quot;Number of Dengue Primary Series Doses Administered&quot; = 1"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="10"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString value="Client's age is between 9 years and 45 years"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@input: Client's age is between 9 years and 45 years
@pseudocode: 9 years ≤ Today's date − &quot;Date of birth&quot; ≤ 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 &quot;Client's age is between 9 years and 45 years&quot;:
  Encounter.&quot;Current Patient Age In Years&quot; &gt;= 9
  and Encounter.&quot;Current Patient Age In Years&quot; &lt;= 45"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="11"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString value="Date of Latest Dengue Dose"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@internal: Date of Latest Dengue Dose
*/
define &quot;Date of Latest Dengue Dose&quot;:
  date from start of &quot;Dengue Doses Administered to Patient&quot;.mostRecent().occurrence.toInterval()"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="12"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString
                       value="The latest dengue dose was administered less than 6 months ago"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@input: The latest dengue dose was administered less than 6 months ago
@pseudocode: Today's date - Latest &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Dengue vaccines&quot;) &lt; 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 &quot;The latest dengue dose was administered less than 6 months ago&quot;:
  &quot;Date of Latest Dengue Dose&quot; is not null
  and duration in months between &quot;Date of Latest Dengue Dose&quot; and Today &lt; 6"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="13"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Client is not due for dengue vaccination Case 3"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Client is not due for dengue vaccination Case 3
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for dengue vaccination Case 3&quot;:
  Encounter.&quot;One dengue primary series dose was administered&quot;
    and Encounter.&quot;Client's age is between 9 years and 45 years&quot;
    and Encounter.&quot;The latest dengue dose was administered less than 6 months ago&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="14"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Two dengue primary series doses were administered"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@input: Two dengue primary series doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Dengue vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 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 &quot;Two dengue primary series doses were administered&quot;:
  &quot;Number of Dengue Primary Series Doses Administered&quot; = 2"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="15"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Client is not due for dengue vaccination Case 4"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Client is not due for dengue vaccination Case 4
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for dengue vaccination Case 4&quot;:
  Encounter.&quot;Two dengue primary series doses were administered&quot;
    and Encounter.&quot;Client's age is between 9 years and 45 years&quot;
    and Encounter.&quot;The latest dengue dose was administered less than 6 months ago&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="16"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString value="Client is not due for dengue vaccination"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Client is not due for dengue vaccination
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Not due&quot;
*/
define &quot;Client is not due for dengue vaccination&quot;:
  &quot;Client is not due for dengue vaccination Case 1&quot;
    or &quot;Client is not due for dengue vaccination Case 2&quot;
    or &quot;Client is not due for dengue vaccination Case 3&quot;
    or &quot;Client is not due for dengue vaccination Case 4&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="17"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Client is not due for dengue vaccination Guidance"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@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 &quot;Client is not due for dengue vaccination Guidance&quot;:
  case
    when &quot;Client is not due for dengue vaccination Case 1&quot; 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 &quot;Client is not due for dengue vaccination Case 2&quot; then 'Should not vaccinate client with first dengue dose as client\'s age is more than 45 years. 
Check for any vaccines due.'
    when &quot;Client is not due for dengue vaccination Case 3&quot; 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 &quot;Client is not due for dengue vaccination Case 4&quot; 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"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="18"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString
                       value="No dengue primary series doses were administered"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@input: No dengue primary series doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Dengue vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 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 &quot;No dengue primary series doses were administered&quot;:
  &quot;Number of Dengue Primary Series Doses Administered&quot; = 0"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="19"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString value="Client is due for dengue vaccination Case 1"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Client is due for dengue vaccination Case 1
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for dengue vaccination Case 1&quot;:
  Encounter.&quot;No dengue primary series doses were administered&quot;
    and Encounter.&quot;Client's age is between 9 years and 45 years&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="20"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString
                       value="The latest dengue dose was administered more than 6 months ago"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@input: The latest dengue dose was administered more than 6 months ago
@pseudocode: Today's date - Latest &quot;Date and time of vaccination&quot; (where &quot;Vaccine type&quot; = &quot;Dengue vaccines&quot;) ≥ 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 &quot;The latest dengue dose was administered more than 6 months ago&quot;:
  &quot;Date of Latest Dengue Dose&quot; is not null
  and duration in months between &quot;Date of Latest Dengue Dose&quot; and Today &gt;= 6"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="21"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString value="Client is due for dengue vaccination Case 2"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Client is due for dengue vaccination Case 2
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for dengue vaccination Case 2&quot;:
  Encounter.&quot;One dengue primary series dose was administered&quot;
    and Encounter.&quot;Client's age is between 9 years and 45 years&quot;
    and Encounter.&quot;The latest dengue dose was administered more than 6 months ago&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="22"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString value="Client is due for dengue vaccination Case 3"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Client is due for dengue vaccination Case 3
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for dengue vaccination Case 3&quot;:
  Encounter.&quot;Two dengue primary series doses were administered&quot;
    and Encounter.&quot;Client's age is between 9 years and 45 years&quot;
    and Encounter.&quot;The latest dengue dose was administered more than 6 months ago&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="23"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString value="Client is due for dengue vaccination"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Client is due for dengue vaccination
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Due&quot;
*/
define &quot;Client is due for dengue vaccination&quot;:
  &quot;Client is due for dengue vaccination Case 1&quot;
    or &quot;Client is due for dengue vaccination Case 2&quot;
    or &quot;Client is due for dengue vaccination Case 3&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="24"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString value="Client is due for dengue vaccination Guidance"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@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 &quot;Client is due for dengue vaccination Guidance&quot;:
  case
    when &quot;Client is due for dengue vaccination Case 1&quot; 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 &quot;Client is due for dengue vaccination Case 2&quot; then 'Should vaccinate client with second dengue dose as latest dengue dose was administered more than 6 months ago. 
Check for contraindications.'
    when &quot;Client is due for dengue vaccination Case 3&quot; then 'Should vaccinate client with third dengue dose as latest dengue dose was administered more than 6 months ago. 
Check for contraindications.'
    else ''
  end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="25"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZD2DTDengueEncounterElements"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Three dengue primary series doses were administered"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@input: Three dengue primary series doses were administered
@pseudocode: Count of vaccines administered (where &quot;Vaccine type&quot; = &quot;Dengue vaccines&quot; and &quot;Type of dose&quot; = &quot;Primary series&quot;) = 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 &quot;Three dengue primary series doses were administered&quot;:
  &quot;Number of Dengue Primary Series Doses Administered&quot; = 3"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="26"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString value="Dengue immunization schedule is complete"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@output: Dengue immunization schedule is complete
@pseudocode: &quot;Immunization recommendation status&quot; = &quot;Complete&quot;
&quot;Completed the primary vaccination series&quot; = TRUE (where &quot;Vaccine type&quot; = &quot;Dengue vaccines&quot;)&quot;
*/
define &quot;Dengue immunization schedule is complete&quot;:
  Encounter.&quot;Three dengue primary series doses were administered&quot;
    and Encounter.&quot;Client's age is between 9 years and 45 years&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="27"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Dengue immunization schedule is complete Guidance"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@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 &quot;Dengue immunization schedule is complete Guidance&quot;:
  'Dengue immunization schedule is complete. Three dengue primary series doses were administered. 
Check for any other vaccines due.'"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="28"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString value="Guidance"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@dynamicValue: Guidance
*/
define &quot;Guidance&quot;:
  case 
    when &quot;Client is not due for dengue vaccination&quot; then &quot;Client is not due for dengue vaccination Guidance&quot;
    when &quot;Client is due for dengue vaccination&quot; then &quot;Client is due for dengue vaccination Guidance&quot;
    when &quot;Dengue immunization schedule is complete&quot; then &quot;Dengue immunization schedule is complete Guidance&quot; 
    else ''
  end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="29"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString
                       value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
        </extension>
        <extension url="name">
          <valueString value="Has Guidance"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Guidance&quot;:
  &quot;Guidance&quot; is not null and &quot;Guidance&quot; != ''"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="30"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZCommon"/>
        </extension>
        <extension url="name">
          <valueString value="seriesPrimary"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/**
 * @description: Gets the doses from the primary series
 */
define fluent function seriesPrimary(immunizations List&lt;Immunization&gt;):
  immunizations I where
    exists( I.protocolApplied pa where pa.series = 'Primary series' )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="31"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToString"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToString(value string): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="32"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToString"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToString(value ImmunizationStatus): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="33"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToBoolean"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToBoolean(value boolean): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="34"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="WHOCommon"/>
        </extension>
        <extension url="name">
          <valueString value="toInterval"/>
        </extension>
        <extension url="statement">
          <valueString
                       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&lt;FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range&gt;):
  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&lt;DateTime&gt;, 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&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')
    else
      null as Interval&lt;DateTime&gt;
  end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="35"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToDateTime"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToDateTime(value dateTime): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="36"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToInterval"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period.&quot;start&quot; is null then
            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]
        else
            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="37"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToDateTime"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToDateTime(value instant): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="38"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToDate"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToDate(value date): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="39"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToQuantity"/>
        </extension>
        <extension url="statement">
          <valueString
                       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: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')
    end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="40"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToCalendarUnit"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="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"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="41"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToConcept"/>
        </extension>
        <extension url="statement">
          <valueString
                       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
        }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="42"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToCode"/>
        </extension>
        <extension url="statement">
          <valueString
                       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
        }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="43"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="WHOCommon"/>
        </extension>
        <extension url="name">
          <valueString value="mostRecent"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define fluent function mostRecent(immunizations List&lt;Immunization&gt;):
  Last(
    immunizations I
      sort by start of occurrence.toInterval()
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="44"/>
        </extension>
      </extension>
      <name value="EffectiveDataRequirements"/>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="module-definition"/>
        </coding>
      </type>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="FHIR model information"/>
        <resource
                  value="http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Encounter"/>
        <resource
                  value="http://smart.who.int/immunizations/Library/IMMZD2DTDengueEncounterElements"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Encounter"/>
        <resource
                  value="http://smart.who.int/immunizations/Library/IMMZEncounterElements"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Common"/>
        <resource
                  value="http://smart.who.int/immunizations/Library/IMMZCommon"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource
                  value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Elements"/>
        <resource
                  value="http://smart.who.int/immunizations/Library/IMMZElements"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library WC"/>
        <resource
                  value="http://smart.who.int/immunizations/Library/WHOCommon"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Concepts"/>
        <resource
                  value="http://smart.who.int/immunizations/Library/IMMZConcepts"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Dengue vaccines"/>
        <resource
                  value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE25"/>
      </relatedArtifact>
      <parameter>
        <name value="Today"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="date"/>
      </parameter>
      <parameter>
        <name value="Guidance"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="string"/>
      </parameter>
      <parameter>
        <name value="Has Guidance"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Client is due for dengue vaccination"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <dataRequirement>
        <type value="Patient"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <mustSupport value="birthDate"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Immunization"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
        <mustSupport value="status"/>
        <mustSupport value="isSubpotent"/>
        <mustSupport value="protocolApplied"/>
        <mustSupport value="occurrence"/>
        <codeFilter>
          <path value="status"/>
          <code>
            <code value="completed"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Immunization"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
        <mustSupport value="occurrence"/>
        <mustSupport value="protocolApplied"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Immunization"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
        <mustSupport value="status"/>
        <mustSupport value="isSubpotent"/>
        <mustSupport value="occurrence"/>
        <mustSupport value="vaccineCode"/>
        <mustSupport value="protocolApplied"/>
        <codeFilter>
          <path value="status"/>
          <code>
            <code value="completed"/>
          </code>
        </codeFilter>
        <codeFilter>
          <path value="vaccineCode"/>
          <valueSet
                    value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE25"/>
        </codeFilter>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
    <valueCode value="computable"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
    <valueCanonical value="#effective-data-requirements"/>
  </extension>
  <url
       value="http://smart.who.int/immunizations/PlanDefinition/IMMZD2DTDengue3DosesWithoutPreVaccinationScreening"/>
  <version value="1.0.0"/>
  <name value="IMMZD2DTDengue3DosesWithoutPreVaccinationScreening"/>
  <title value="IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening"/>
  <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.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]"/>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="WHO recommendations for routine immunization - summary tables (January 2025)"/>
  </relatedArtifact>
  <library
           value="http://smart.who.int/immunizations/Library/IMMZD2DTDengue3DosesWithoutPreVaccinationScreeningLogic"/>
  <action>
    <extension
               url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
      <valueMarkdown
                     value="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."/>
    </extension>
    <title value="Determine if the client is due for Dengue."/>
    <description
                 value="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]"/>
    <condition>
      <kind value="applicability"/>
      <expression>
        <description value="Client is due for dengue vaccination"/>
        <language value="text/cql-identifier"/>
        <expression value="Client is due for dengue 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: 'DE25', display: 'Dengue vaccines' } }, display: 'Dengue vaccines' }"/>
      </expression>
    </dynamicValue>
  </action>
  <action>
    <title
           value="Check for Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening."/>
    <description
                 value="Show Guidance for the patient regarding IMMZ.D2.DT.Dengue.3 doses without pre-vaccination screening."/>
    <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>