Id: IMMZD2DTMeaslesSupplementaryDose Url: IMMZ.D2.DT.Measles.Supplementary dose Version: 1.0.0 Title: IMMZ.D2.DT.Measles.Supplementary dose 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.Supplementary dose Measles-containing vaccine (MCV) supplementary dose administration Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD2DTMeaslesSupplementaryDoseLogic Actions: Check for Guidance for the patient regarding IMMZ.D2.DT.Measles.Supplementary dose.: Show Guidance for the patient regarding IMMZ.D2.DT.Measles.Supplementary dose. 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' })
Completed the primary vaccination series
/** * @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 Supplementary Doses Administered to Patient
/* @internal: MCV Supplementary Doses Administered to Patient */ define "MCV Supplementary Doses Administered to Patient": "MCV Doses Administered to Patient".seriesSupplementary()
/* @internal: MCV Supplementary Doses Administered to Patient */ define "MCV Supplementary Doses Administered to Patient": MeaslesElements."MCV Supplementary Doses Administered to Patient".onOrBefore(Today)
Number of MCV Supplementary Doses Administered
/* @internal: Number of MCV Supplementary Doses Administered */ define "Number of MCV Supplementary Doses Administered": Count("MCV Supplementary Doses Administered to Patient")
Measles supplementary dose was not administered
/* @input: Measles supplementary dose was not administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Supplementary dose") = 0 @code: Measles supplementary dose was not administered-131 @decision: IMMZ.D2.DT.Measles.Supplementary dose: Measles-containing vaccine (MCV) supplementary dose administration */ define "Measles supplementary dose was not administered": "Number of MCV Supplementary Doses Administered" = 0
MCV Primary Series Doses Administered to Patient
/* @internal: MCV Primary Series Doses Administered to Patient */ define "MCV Primary Series Doses Administered to Patient": "MCV Doses Administered to Patient".seriesPrimary()
/* @internal: MCV Primary Series Doses Administered to Patient */ define "MCV Primary Series Doses Administered to Patient": MeaslesElements."MCV Primary Series Doses Administered to Patient".onOrBefore(Today)
Number of MCV Primary Series Doses Administered
/* @internal: Number of MCV Primary Series Doses Administered */ define "Number of MCV Primary Series Doses Administered": Count("MCV Primary Series Doses Administered to Patient")
/* @input: MCV2 was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Primary series") = 2 @code: MCV2 was administered-127 @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) */ define "MCV2 was administered": "Number of MCV Primary Series Doses Administered" = 2
/* @internal: MCV Doses Administered to Patient */ define "MCV Doses Administered to Patient": MeaslesElements."MCV Doses Administered to Patient".onOrBefore(Today)
Completed the primary vaccination series Observation
/* @internal: Completed the primary vaccination series Observation */ define "Completed the primary vaccination series Observation": ([Observation: Concepts."Completed the primary vaccination series"]).complete()
/* @internal: Completed the primary vaccination series Observation */ define "Completed the primary vaccination series Observation": Elements."Completed the primary vaccination series Observation".encounterOrOnBefore(EncounterId, Today)
Measles routine immunization schedule is complete
/* @input: Measles routine immunization schedule is complete @pseudocode: "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Measles-containing vaccines") @code: Measles routine immunization schedule is complete-104 @decision: IMMZ.D2.DT.Measles.Supplementary dose: Measles-containing vaccine (MCV) supplementary dose administration */ define "Measles routine immunization schedule is complete": "MCV2 was administered" or Coalesce( "MCV Doses Administered to Patient" Dose aggregate Result: Encounter."Completed the primary vaccination series Observation".partOf.references(Dose) or Result, false )
/* @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"
Live vaccine was administered in the past 4 weeks
/* @input: Live vaccine was administered in the past 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 past 4 weeks-92 @decision: IMMZ.D2.DT.Measles.Supplementary dose: Measles-containing vaccine (MCV) supplementary dose administration */ define "Live vaccine was administered in the past 4 weeks": "Live vaccine was administered in the last 4 weeks"
Client is not due for measles supplementary dose
/* @output: Client is not due for measles supplementary dose @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for measles supplementary dose": Encounter."Measles supplementary dose was not administered" and Encounter."Measles routine immunization schedule is complete" and Encounter."Live vaccine was administered in the past 4 weeks"
Client is not due for measles supplementary dose Guidance
/* @output: Client is not due for measles supplementary dose Guidance @guidance: Should not vaccinate client with measles supplementary dose 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 supplementary dose. */ define "Client is not due for measles supplementary dose Guidance": 'Should not vaccinate client with measles supplementary dose 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 supplementary dose.'
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"
No live vaccine was administered in the past 4 weeks
/* @input: No live vaccine was administered in the past 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 past 4 weeks-92 @decision: IMMZ.D2.DT.Measles.Supplementary dose: Measles-containing vaccine (MCV) supplementary dose administration */ define "No live vaccine was administered in the past 4 weeks": "No live vaccine was administered in the last 4 weeks"
Consider measles supplementary dose. Create a clinical note
/* @output: Consider measles supplementary dose. Create a clinical note @pseudocode: "Immunization recommendation status" = "Further evaluation needed" */ define "Consider measles supplementary dose. Create a clinical note": Encounter."Measles supplementary dose was not administered" and Encounter."Measles routine immunization schedule is complete" and Encounter."No live vaccine was administered in the past 4 weeks"
Consider measles supplementary dose. Create a clinical note Guidance
/* @output: Consider measles supplementary dose. Create a clinical note Guidance @guidance: May vaccinate client with measles supplementary dose as supplementary dose was not administered, measles routine immunization schedule is complete and no live vaccine administered in the past 4 weeks. Check if one of the measles supplementary dose specific scenarios is applicable. */ define "Consider measles supplementary dose. Create a clinical note Guidance": 'May vaccinate client with measles supplementary dose as supplementary dose was not administered, measles routine immunization schedule is complete and no live vaccine administered in the past 4 weeks. Check if one of the measles supplementary dose specific scenarios is applicable.'
Measles supplementary dose was administered
/* @input: Measles supplementary dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Measles-containing vaccines" and "Type of dose" = "Supplementary dose") = 1 @code: Measles supplementary dose was administered-131 @decision: IMMZ.D2.DT.Measles.Supplementary dose: Measles-containing vaccine (MCV) supplementary dose administration */ define "Measles supplementary dose was administered": "Number of MCV Supplementary Doses Administered" = 1
Measles immunization schedule is complete
/* @output: Measles immunization schedule is complete @pseudocode: "Immunization recommendation status" = "Complete" */ define "Measles immunization schedule is complete": Encounter."Measles supplementary dose was administered"
Measles immunization schedule is complete Guidance
/* @output: Measles immunization schedule is complete Guidance @guidance: Measles immunization schedule is complete. Measles supplementary dose was administered. */ define "Measles immunization schedule is complete Guidance": 'Measles immunization schedule is complete. Measles supplementary dose was administered.'
/* @dynamicValue: Guidance */ define "Guidance": case when "Client is not due for measles supplementary dose" then "Client is not due for measles supplementary dose Guidance" when "Consider measles supplementary dose. Create a clinical note" then "Consider measles supplementary dose. Create a clinical note Guidance" when "Measles immunization schedule is complete" then "Measles immunization schedule is complete 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 Supplementary series */ define fluent function seriesSupplementary(immunizations List<Immunization>): immunizations I where exists( I.protocolApplied pa where pa.series = 'Supplementary dose' )
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 }
/** * @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' )
/* @description: Returns true if any of the given references are to the given resource @comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references. NOTE: This function assumes resources from the same source server. */ define fluent function references(references List<FHIR.Reference>, resource FHIR.Resource): exists (references R where R.references(resource))
/* @description: Returns true if the given reference is to the given resource @comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference. NOTE: This function assumes resources from the same source server. */ define fluent function references(reference FHIR.Reference, resource FHIR.Resource): resource.id = Last(Split(reference.reference, '/'))
/** * @description: Gets observation from an encounter or on or before a date */ define fluent function encounterOrOnBefore(observations List<Observation>, EncounterId String, beforeDate Date): observations O where (O.encounter.references(EncounterId) or O.effective.toInterval() starts same day or before beforeDate)
/* @description: Returns true if the given reference is to the given resourceId @comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference. NOTE: This function assumes resources from the same source server. */ define fluent function references(reference FHIR.Reference, resourceId String): resourceId = Last(Split(reference.reference, '/'))
define fluent function complete(observations List<Observation>): observations O where O.status in { 'final', 'amended', 'corrected' }
define function ToString(value ObservationStatus): value.value
define fluent function mostRecent(immunizations List<Immunization>): Last( immunizations I sort by start of occurrence.toInterval() )
IMMZ.D2.DT.Measles.Supplementary dose Measles-containing vaccine (MCV) supplementary dose administration
WHO recommendations for routine immunization - summary tables (January 2025)
Check for Guidance for the patient regarding IMMZ.D2.DT.Measles.Supplementary dose.
Show Guidance for the patient regarding IMMZ.D2.DT.Measles.Supplementary dose.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }