Id: IMMZD2DTMalaria Url: IMMZ.D2.DT.Malaria Version: 1.0.0 Title: IMMZ.D2.DT.Malaria 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.Malaria 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD2DTMalariaLogic Actions: Determine if the client is due for Malaria.: Determine if the client is due for Malaria vaccine according to the national immunization protocol. 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) If: Applicability: Client is due for malaria vaccination (Client is due for malaria vaccination) Then: Definition: IMMZD2DTMR Dynamic Values: status: ('draft') intent: ('proposal') medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE27', display: 'Malaria vaccines' } }, display: 'Malaria vaccines' }) Check for Guidance for the patient regarding IMMZ.D2.DT.Malaria.: Show Guidance for the patient regarding IMMZ.D2.DT.Malaria. 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 months */ define "Current Patient Age In Months": AgeInMonthsAt(Today)
/* @input: Client's age is less than 5 months @pseudocode: Today's date − "Date of birth" < 5 months @code: Client's age is less than 5 months-41 @decision: IMMZ.D2.DT.Malaria: 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) */ define "Client's age is less than 5 months": Encounter."Current Patient Age In Months" < 5
Client is not due for malaria vaccination Case 1
/* @output: Client is not due for malaria vaccination Case 1 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for malaria vaccination Case 1": Encounter."Client's age is less than 5 months"
/** * @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: Malaria containing Doses Administered to Patient */ define "Malaria Doses Administered to Patient": Encounter."Doses Administered to Patient" I where I.vaccineCode in Concepts."Malaria vaccines"
Malaria Primary Series Doses Administered to Patient
/* @internal: Malaria containing Doses Administered to Patient that are in the Primary series */ define "Malaria Primary Series Doses Administered to Patient": "Malaria Doses Administered to Patient".seriesPrimary()
Number of Malaria Primary Series Doses Administered
/* @internal: Number of Malaria Primary Series doses */ define "Number of Malaria Primary Series Doses Administered": Count("Malaria Primary Series Doses Administered to Patient")
One malaria primary series dose was administered
/* @input: One malaria primary series dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Malaria vaccines" and "Type of dose" = "Primary series") = 1 @code: One malaria primary series dose was administered-116 @decision: IMMZ.D2.DT.Malaria: 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) */ define "One malaria primary series dose was administered": "Number of Malaria Primary Series Doses Administered" = 1
/* @internal: Date of Latest Malaria Dose */ define "Date of Latest Malaria Dose": date from start of "Malaria Doses Administered to Patient".mostRecent().occurrence.toInterval()
The latest malaria dose was administered less than 4 weeks ago
/* @input: The latest malaria dose was administered less than 4 weeks ago @pseudocode: Today's date − "Date and time of vaccination" (where "Vaccine type" = "Malaria vaccines") < 4 weeks @code: The latest malaria dose was administered less than 4 weeks ago-99 @decision: IMMZ.D2.DT.Malaria: 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) */ define "The latest malaria dose was administered less than 4 weeks ago": "Date of Latest Malaria Dose" is not null and duration in weeks between "Date of Latest Malaria Dose" and Today < 4
Client is not due for malaria vaccination Case 2
/* @output: Client is not due for malaria vaccination Case 2 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for malaria vaccination Case 2": Encounter."One malaria primary series dose was administered" and Encounter."The latest malaria dose was administered less than 4 weeks ago"
Two malaria primary series doses were administered
/* @input: Two malaria primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Malaria vaccines" and "Type of dose" = "Primary series") = 2 @code: Two malaria primary series doses were administered-116 @decision: IMMZ.D2.DT.Malaria: 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) */ define "Two malaria primary series doses were administered": "Number of Malaria Primary Series Doses Administered" = 2
Client is not due for malaria vaccination Case 3
/* @output: Client is not due for malaria vaccination Case 3 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for malaria vaccination Case 3": Encounter."Two malaria primary series doses were administered" and Encounter."The latest malaria dose was administered less than 4 weeks ago"
Three malaria primary series doses were administered
/* @input: Three malaria primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Malaria vaccines" and "Type of dose" = "Primary series") = 3 @code: Three malaria primary series doses were administered-116 @decision: IMMZ.D2.DT.Malaria: 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) */ define "Three malaria primary series doses were administered": "Number of Malaria Primary Series Doses Administered" = 3
Client is not due for malaria vaccination Case 4
/* @output: Client is not due for malaria vaccination Case 4 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for malaria vaccination Case 4": Encounter."Three malaria primary series doses were administered" and Encounter."The latest malaria dose was administered less than 4 weeks ago"
Client is not due for malaria vaccination
/* @output: Client is not due for malaria vaccination @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for malaria vaccination": "Client is not due for malaria vaccination Case 1" or "Client is not due for malaria vaccination Case 2" or "Client is not due for malaria vaccination Case 3" or "Client is not due for malaria vaccination Case 4"
Client is not due for malaria vaccination Guidance
/* @output: Client is not due for malaria vaccination Guidance @guidance = Should not vaccinate client with first malaria dose as client's age is less than 5 months. Check for any other vaccines due and inform the caregiver of when to come back for first dose. @guidance = Should not vaccinate client with second malaria dose as the latest malaria dose was administered less than 4 weeks 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 malaria dose as the latest malaria dose was administered less than 4 weeks ago. Check for any other vaccines due and inform the caregiver of when to come back for the third dose. @guidance = Should not vaccinate client with fourth malaria dose as the latest malaria dose was administered less than 4 weeks ago. Check for any other vaccines due and inform the caregiver of when to come back for the fourth dose. */ define "Client is not due for malaria vaccination Guidance": case when "Client is not due for malaria vaccination Case 1" then 'Should not vaccinate client with first malaria dose as client\'s age is less than 5 months. Check for any other vaccines due and inform the caregiver of when to come back for first dose.' when "Client is not due for malaria vaccination Case 2" then 'Should not vaccinate client with second malaria dose as the latest malaria dose was administered less than 4 weeks 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 malaria vaccination Case 3" then 'Should not vaccinate client with third malaria dose as the latest malaria dose was administered less than 4 weeks ago. Check for any other vaccines due and inform the caregiver of when to come back for the third dose.' when "Client is not due for malaria vaccination Case 4" then 'Should not vaccinate client with fourth malaria dose as the latest malaria dose was administered less than 4 weeks ago. Check for any other vaccines due and inform the caregiver of when to come back for the fourth dose.' else '' end
No malaria primary series doses were administered
/* @input: No malaria primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Malaria vaccines" and "Type of dose" = "Primary series") = 0 @code: No malaria primary series doses were administered-116 @decision: IMMZ.D2.DT.Malaria: 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) */ define "No malaria primary series doses were administered": "Number of Malaria Primary Series Doses Administered" = 0
Client's age is more than or equal to 5 months
/* @input: Client's age is more than or equal to 5 months @pseudocode: Today's date − "Date of birth" ≥ 5 months @code: Client's age is more than or equal to 5 months-41 @decision: IMMZ.D2.DT.Malaria: 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) */ define "Client's age is more than or equal to 5 months": Encounter."Current Patient Age In Months" >= 5
Client is due for malaria vaccination Case 1
/* @output: Client is due for malaria vaccination Case 1 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for malaria vaccination Case 1": Encounter."No malaria primary series doses were administered" and Encounter."Client's age is more than or equal to 5 months"
The latest malaria dose was administered more than 4 weeks ago
/* @input: The latest malaria dose was administered more than 4 weeks ago @pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "Malaria vaccines") ≥ 4 weeks @code: The latest malaria dose was administered more than 4 weeks ago-106 @decision: IMMZ.D2.DT.Malaria: 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) */ define "The latest malaria dose was administered more than 4 weeks ago": not "The latest malaria dose was administered less than 4 weeks ago"
Client is due for malaria vaccination Case 2
/* @output: Client is due for malaria vaccination Case 2 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for malaria vaccination Case 2": Encounter."One malaria primary series dose was administered" and Encounter."The latest malaria dose was administered more than 4 weeks ago"
Client is due for malaria vaccination Case 3
/* @output: Client is due for malaria vaccination Case 3 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for malaria vaccination Case 3": Encounter."Two malaria primary series doses were administered" and Encounter."The latest malaria dose was administered more than 4 weeks ago"
Client is due for malaria vaccination Case 4
/* @output: Client is due for malaria vaccination Case 4 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for malaria vaccination Case 4": Encounter."Three malaria primary series doses were administered" and Encounter."The latest malaria dose was administered more than 4 weeks ago"
/* @output: Client is due for malaria vaccination @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for malaria vaccination": "Client is due for malaria vaccination Case 1" or "Client is due for malaria vaccination Case 2" or "Client is due for malaria vaccination Case 3" or "Client is due for malaria vaccination Case 4"
Client is due for malaria vaccination Guidance
/* @output: Client is due for malaria vaccination Guidance @guidance = Should vaccinate client with first malaria dose as no malaria doses were administered and client is within appropriate age range. Check for contraindications. @guidance = Should vaccinate client with second malaria dose as the latest malaria dose was administered more than 4 weeks ago. Check for contraindications. @guidance = Should vaccinate client with third malaria dose as the latest malaria dose was administered more than 4 weeks ago. Check for contraindications. @guidance = Should vaccinate client with fourth malaria dose as the latest malaria dose was administered more than 4 weeks ago. Check for contraindications. */ define "Client is due for malaria vaccination Guidance": case when "Client is due for malaria vaccination Case 1" then 'Should vaccinate client with first malaria dose as no malaria doses were administered and client is within appropriate age range. Check for contraindications.' when "Client is due for malaria vaccination Case 2" then 'Should vaccinate client with second malaria dose as the latest malaria dose was administered more than 4 weeks ago. Check for contraindications.' when "Client is due for malaria vaccination Case 3" then 'Should vaccinate client with third malaria dose as the latest malaria dose was administered more than 4 weeks ago. Check for contraindications.' when "Client is due for malaria vaccination Case 4" then 'Should vaccinate client with fourth malaria dose as the latest malaria dose was administered more than 4 weeks ago. Check for contraindications.' else '' end
Four malaria primary series doses were administered
/* @input: Four malaria primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Malaria vaccines" and "Type of dose" = "Primary series") = 4 @code: Four malaria primary series doses were administered-116 @decision: IMMZ.D2.DT.Malaria: 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO) */ define "Four malaria primary series doses were administered": "Number of Malaria Primary Series Doses Administered" = 4
Malaria immunization schedule is complete
/* @output: Malaria immunization schedule is complete @pseudocode: "Immunization recommendation status" = "Complete" "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Malaria vaccines")" */ define "Malaria immunization schedule is complete": Encounter."Four malaria primary series doses were administered"
Malaria immunization schedule is complete Guidance
/* @output: Malaria immunization schedule is complete Guidance @guidance: Malaria immunization schedule is complete. Four malaria primary series doses were administered. Check for any other vaccines due. */ define "Malaria immunization schedule is complete Guidance": 'Malaria immunization schedule is complete. Four malaria primary series doses were administered. Check for any other vaccines due.'
/* @dynamicValue: Guidance */ define "Guidance": case when "Client is not due for malaria vaccination" then "Client is not due for malaria vaccination Guidance" when "Client is due for malaria vaccination" then "Client is due for malaria vaccination Guidance" when "Malaria immunization schedule is complete" then "Malaria 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.Malaria 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO)
WHO recommendations for routine immunization - summary tables (January 2025)
The vaccine should be administered in a 3-dose primary schedule, with a fourth dose provided approximately 12–18 months after the third dose to prolong the duration of protection. There should be a minimum interval of 4 weeks between doses.
Determine if the client is due for Malaria.
Determine if the client is due for Malaria vaccine according to the national immunization protocol. 4-dose schedule (The RTS,S/AS01 malaria vaccine should be used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate to high malaria transmission, as defined by WHO)
Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE27', display: 'Malaria vaccines' } }, display: 'Malaria vaccines' }
Check for Guidance for the patient regarding IMMZ.D2.DT.Malaria.
Show Guidance for the patient regarding IMMZ.D2.DT.Malaria.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }