Id: IMMZD2DTMeaslesMCVDose0 Url: IMMZ.D2.DT.Measles.MCV dose 0 Version: 1.0.0 Title: IMMZ.D2.DT.Measles.MCV dose 0 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.Measles.MCV dose 0 Measles-containing vaccine dose 0 (MCV0) administration Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD2DTMeaslesMCVDose0Logic Actions: Check for Guidance for the patient regarding IMMZ.D2.DT.Measles.MCV dose 0.: Show Guidance for the patient regarding IMMZ.D2.DT.Measles.MCV dose 0. 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 6 months @pseudocode: Today's date − "Date of birth" < 6 months @code: Client's age is less than 6 months-41 @decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration */ define "Client's age is less than 6 months": Encounter."Current Patient Age In Months" < 6
/* @output: Client is not due for MCV0 Case 1 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for MCV0 Case 1": Encounter."Client's age is less than 6 months"
/** * @dataElement All Doses Administered to Patient */ define "Doses Administered to Patient": [Immunization] I where I.status = 'completed' and I.isSubpotent is not true
/* @internal: MCV Doses Administered to Patient */ define "MCV Doses Administered to Patient": Elements."Doses Administered to Patient" I where I.vaccineCode in Concepts."Measles-containing vaccines"
MCV Dose 0 Doses Administered to Patient
/* @internal: MCV Dose 0 Doses Administered to Patient */ define "MCV Dose 0 Doses Administered to Patient": "MCV Doses Administered to Patient".seriesDose0()
/* @internal: MCV Dose 0 Doses Administered to Patient */ define "MCV Dose 0 Doses Administered to Patient": MeaslesElements."MCV Dose 0 Doses Administered to Patient".onOrBefore(Today)
/* @internal: Number of MCV Dose 0 Doses Administered */ define "Number of MCV Dose 0 Doses Administered": Count("MCV Dose 0 Doses Administered to Patient")
/* @input: MCV0 was not administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Dose 0") = 0 @code: MCV0 was not administered-119 @decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration */ define "MCV0 was not administered": "Number of MCV Dose 0 Doses Administered" = 0
Client's age is between 6 months and 9 months
/* @input: Client's age is between 6 months and 9 months @pseudocode: 6 months ≤ Today's date − "Date of birth" < 9 months @code: Client's age is between 6 months and 9 months-52 @decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration */ define "Client's age is between 6 months and 9 months": 6 <= Encounter."Current Patient Age In Months" and Encounter."Current Patient Age In Months" < 9
/* @dataElement: Live attenuated vaccines */ define "Live Attenuated Vaccines": "Doses Administered to Patient" I where I.vaccineCode in Concepts."Live Attenuated"
/* @dataElement Live attenuated vaccines */ define "Live Attenuated Vaccines": Elements."Live Attenuated Vaccines" I where I.occurrence.toInterval() same day or before Today
/* @dataElement Date and time of last live attenuated vaccine */ define "Date of Latest Live Attenuated Vaccine": date from start of "Live Attenuated Vaccines".mostRecent().occurrence.toInterval()
Live vaccine was administered in the last 4 weeks
/* @input: Live vaccine was administered in the last 4 weeks @pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) < 4 weeks */ define "Live vaccine was administered in the last 4 weeks": "Date of Latest Live Attenuated Vaccine" is not null and duration in weeks between "Date of Latest Live Attenuated Vaccine" and Today < 4
/* @input: Live vaccine was administered in the last 4 weeks @pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) < 4 weeks @code: Live vaccine was administered in the last 4 weeks-92 @decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months) @decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months) @decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration */ define "Live vaccine was administered in the last 4 weeks": Encounter."Live vaccine was administered in the last 4 weeks"
/* @output: Client is not due for MCV0 Case 2 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for MCV0 Case 2": Encounter."MCV0 was not administered" and Encounter."Client's age is between 6 months and 9 months" and Encounter."Live vaccine was administered in the last 4 weeks"
Client's age is more than or equal to 9 months
/* @input: Client's age is more than or equal to 9 months @pseudocode: Today's date − "Date of birth" ≥ 9 months @code: Client's age is more than or equal to 9 months-41 @decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months) @decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration */ define "Client's age is more than or equal to 9 months": Encounter."Current Patient Age In Months" >= 9
/* @output: Client is not due for MCV0 Case 3 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for MCV0 Case 3": Encounter."Client's age is more than or equal to 9 months"
/* @input: MCV0 was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Dose 0") = 1 @code: MCV0 was administered-119 @decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration */ define "MCV0 was administered": "Number of MCV Dose 0 Doses Administered" = 1
/* @output: Client is not due for MCV0 Case 4 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for MCV0 Case 4": Encounter."MCV0 was administered"
/* @output: Client is not due for MCV0 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for MCV0": "Client is not due for MCV0 Case 1" or "Client is not due for MCV0 Case 2" or "Client is not due for MCV0 Case 3" or "Client is not due for MCV0 Case 4"
/* @output: Client is not due for MCV0 Guidance @guidance = Should not vaccinate client with MCV0 as client's age is less than 6 months. Check for any vaccines due and inform the caregiver of when to come back for MCV0. @guidance = Should not vaccinate client with MCV0 as live vaccine was administered in the past 4 weeks. Check for any vaccines due and inform the caregiver of when to come back for MCV0. @guidance = Should not vaccinate client with MCV0 as client's age is more than 9 months. Check measles routine immunization schedule. @guidance = MCV0 was administered. Check measles routine immunization schedule. */ define "Client is not due for MCV0 Guidance": case when "Client is not due for MCV0 Case 1" then 'Should not vaccinate client with MCV0 as client\'s age is less than 6 months. Check for any vaccines due and inform the caregiver of when to come back for MCV0.' when "Client is not due for MCV0 Case 2" then 'Should not vaccinate client with MCV0 as live vaccine was administered in the past 4 weeks. Check for any vaccines due and inform the caregiver of when to come back for MCV0.' when "Client is not due for MCV0 Case 3" then 'Should not vaccinate client with MCV0 as client\'s age is more than 9 months. Check measles routine immunization schedule.' when "Client is not due for MCV0 Case 4" then 'MCV0 was administered. Check measles routine immunization schedule.' else '' end
No live vaccine was administered in the last 4 weeks
/* @input: No live vaccine was administered in the last 4 weeks @pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) ≥ 4 weeks */ define "No live vaccine was administered in the last 4 weeks": not("Live vaccine was administered in the last 4 weeks")
/* @input: No live vaccine was administered in the last 4 weeks @pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) ≥ 4 weeks @code: No live vaccine was administered in the last 4 weeks-92 @decision: IMMZ.D2.DT.Measles.Ongoing transmission: Countries with ongoing transmission in which the risk of measles mortality remains high (countries that provide first dose of measles-containing vaccine (MCV) at 9 months and second dose of MCV at 15 months) @decision: IMMZ.D2.DT.Measles.Low transmission: Countries with low levels of measles transmission (countries that provide first dose of measles-containing vaccine (MCV) at 12 months and second dose of MCV at 15 months) @decision: IMMZ.D2.DT.Measles.MCV dose 0: Measles-containing vaccine dose 0 (MCV0) administration */ define "No live vaccine was administered in the last 4 weeks": Encounter."No live vaccine was administered in the last 4 weeks"
/* @output: Consider MCV0. @pseudocode: Create a clinical note. "Immunization recommendation status" = "Further evaluation needed" */ define "Consider MCV0.": Encounter."MCV0 was not administered" and Encounter."Client's age is between 6 months and 9 months" and Encounter."No live vaccine was administered in the last 4 weeks"
/* @output: Consider MCV0. Guidance @guidance: May vaccinate client with MCV0 as client is within appropriate age range, MCV0 was not administered and no live vaccine was administered in the past 4 weeks. Check if one of the MCV0 specific scenarios is applicable. */ define "Consider MCV0. Guidance": 'May vaccinate client with MCV0 as client is within appropriate age range, MCV0 was not administered and no live vaccine was administered in the past 4 weeks. Check if one of the MCV0 specific scenarios is applicable.'
/* @dynamicValue: Guidance */ define "Guidance": case when "Client is not due for MCV0" then "Client is not due for MCV0 Guidance" when "Consider MCV0." then "Consider MCV0. Guidance" else '' end
define "Has Guidance": "Guidance" is not null and "Guidance" != ''
/** * @description: Gets immunizations on or before a date */ define fluent function onOrBefore(immunizations List<Immunization>, beforeDate Date): immunizations I where I.occurrence.toInterval() same day or before beforeDate
/* 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
/** * @description: Gets the doses from the dose 0 series */ define fluent function seriesDose0(immunizations List<Immunization>): immunizations I where exists( I.protocolApplied pa where pa.series = 'Dose 0' )
define function ToString(value string): value.value
define function ToString(value ImmunizationStatus): value.value
define function ToBoolean(value boolean): value.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 }
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.Measles.MCV dose 0 Measles-containing vaccine dose 0 (MCV0) administration
WHO recommendations for routine immunization - summary tables (January 2025)
Check for Guidance for the patient regarding IMMZ.D2.DT.Measles.MCV dose 0.
Show Guidance for the patient regarding IMMZ.D2.DT.Measles.MCV dose 0.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }