Id: IMMZD2DTPolioBirthDose Url: IMMZ.D2.DT.Polio.Birth dose Version: 1.0.0 Title: IMMZ.D2.DT.Polio.Birth 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.Polio.Birth dose Birth dose administration as part of "bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (in countries that are poliomyelitis (polio)-endemic countries or at high risk of importation and subsequent spread of polio that follow the combined bOPV–IPV schedule) Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD2DTPolioBirthDoseLogic Actions: Determine if the client is due for a poliovirus vaccination according to the national immunization schedule: Determine if the client is due for a poliovirus vaccination according to the national immunization schedule Birth dose administration as part of "bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (in countries that are poliomyelitis (polio)-endemic countries or at high risk of importation and subsequent spread of polio that follow the combined bOPV–IPV schedule) If: Applicability: Client is due for the bOPV birth dose (Client is due for the bOPV birth dose) Then: Definition: IMMZD2DTMR Dynamic Values: status: ('draft') intent: ('proposal') medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE30', display: 'Oral polio vaccines' } }, display: 'Oral polio vaccines' }) Check for Guidance for the patient regarding IMMZ.D2.DT.Polio.Birth dose.: Show Guidance for the patient regarding IMMZ.D2.DT.Polio.Birth 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' })
/** * @dataElement All Doses Administered to Patient */ define "Doses Administered to Patient": [Immunization] I where I.status = 'completed' and I.isSubpotent is not true
/* @internal: Polio containing Doses Administered to Patient */ define "Polio Doses Administered to Patient": Elements."Doses Administered to Patient" I where I.vaccineCode in Concepts."Poliovirus-containing vaccines"
Polio Dose 0 Doses Administered to Patient
/* @internal: Polio Dose 0 Doses Administered to Patient */ define "Polio Dose 0 Doses Administered to Patient": "Polio Doses Administered to Patient".seriesDose0()
/* @internal: Polio Dose 0 Doses Administered to Patient */ define "Polio Dose 0 Doses Administered to Patient": PolioElements."Polio Dose 0 Doses Administered to Patient".onOrBefore(Today)
Number of Polio Dose 0 Doses Administered
/* @internal: Number of Polio Dose 0 Doses Administered */ define "Number of Polio Dose 0 Doses Administered": Count("Polio Dose 0 Doses Administered to Patient")
bOPV birth dose (a zero dose) was not administered
/* @input: bOPV birth dose (a zero dose) was not administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Poliovirus-containing vaccines" and "Type of dose" = "Dose 0" AND "Birth dose" = TRUE) = 0 @code: bOPV birth dose (a zero dose) was not administered-146 @decision: IMMZ.D2.DT.Polio.Birth dose: Birth dose administration as part of "bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (in countries that are poliomyelitis (polio)-endemic countries or at high risk of importation and subsequent spread of polio that follow the combined bOPV–IPV schedule) */ define "bOPV birth dose (a zero dose) was not administered": "Number of Polio Dose 0 Doses Administered" = 0
/** * @dataElement Patient age in weeks */ define "Current Patient Age In Weeks": AgeInWeeksAt(Today)
/* @input: Client's age is less than 1 week @pseudocode: Today's date − "Date of birth" < 1 week @code: Client's age is less than 1 week-39 @decision: IMMZ.D2.DT.Polio.Birth dose: Birth dose administration as part of "bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (in countries that are poliomyelitis (polio)-endemic countries or at high risk of importation and subsequent spread of polio that follow the combined bOPV–IPV schedule) */ define "Client's age is less than 1 week": Encounter."Current Patient Age In Weeks" < 1
/* @output: Client is due for the bOPV birth dose @pseudocode: "Immunization recommendation status" = "Due" (where "Type of poliovirus dose" = "bOPV") */ define "Client is due for the bOPV birth dose": Encounter."bOPV birth dose (a zero dose) was not administered" and Encounter."Client's age is less than 1 week"
Client is due for the bOPV birth dose Guidance
/* @output: Client is due for the bOPV birth dose Guidance @guidance: Should vaccinate client with bOPV birth dose (a zero dose) as poliovirus birth dose was not administered and client's age is less than 1 week. Check for contraindications. */ define "Client is due for the bOPV birth dose Guidance": 'Should vaccinate client with bOPV birth dose (a zero dose) as poliovirus birth dose was not administered and client\'s age is less than 1 week. Check for contraindications.'
Client's age is more than or equal to 1 week
/* @input: Client's age is more than or equal to 1 week @pseudocode: Today's date − "Date of birth" ≥ 1 week @code: Client's age is more than or equal to 1 week-39 @decision: IMMZ.D2.DT.Polio.Birth dose: Birth dose administration as part of "bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (in countries that are poliomyelitis (polio)-endemic countries or at high risk of importation and subsequent spread of polio that follow the combined bOPV–IPV schedule) */ define "Client's age is more than or equal to 1 week": Encounter."Current Patient Age In Weeks" >= 1
Client is not due for the bOPV birth dose Case 1
/* @output: Client is not due for the bOPV birth dose Case 1 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for the bOPV birth dose Case 1": Encounter."bOPV birth dose (a zero dose) was not administered" and Encounter."Client's age is more than or equal to 1 week"
bOPV birth dose (a zero dose) was administered
/* @input: bOPV birth dose (a zero dose) was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Poliovirus-containing vaccines" and "Type of dose" = "Dose 0" AND "Birth dose" = TRUE) = 1 @code: bOPV birth dose (a zero dose) was administered-146 @decision: IMMZ.D2.DT.Polio.Birth dose: Birth dose administration as part of "bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (in countries that are poliomyelitis (polio)-endemic countries or at high risk of importation and subsequent spread of polio that follow the combined bOPV–IPV schedule) */ define "bOPV birth dose (a zero dose) was administered": "Number of Polio Dose 0 Doses Administered" = 1
Client is not due for the bOPV birth dose Case 2
/* @output: Client is not due for the bOPV birth dose Case 2 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for the bOPV birth dose Case 2": Encounter."bOPV birth dose (a zero dose) was administered"
Client is not due for the bOPV birth dose
/* @output: Client is not due for the bOPV birth dose @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for the bOPV birth dose": "Client is not due for the bOPV birth dose Case 1" or "Client is not due for the bOPV birth dose Case 2"
Client is not due for the bOPV birth dose Guidance
/* @output: Client is not due for the bOPV birth dose Guidance @guidance = Should not vaccinate client with bOPV birth dose (a zero dose) as client's age is more than or equal to 1 week. Check for any other vaccines due and inform the caregiver of when to come back for the next dose. @guidance = Poliovirus birth dose was already administered. Check poliovirus immunization schedule. */ define "Client is not due for the bOPV birth dose Guidance": case when "Client is not due for the bOPV birth dose Case 1" then 'Should not vaccinate client with bOPV birth dose (a zero dose) as client\'s age is more than or equal to 1 week. Check for any other vaccines due and inform the caregiver of when to come back for the next dose.' when "Client is not due for the bOPV birth dose Case 2" then 'Poliovirus birth dose was already administered. Check poliovirus immunization schedule.' else '' end
/* @dynamicValue: Guidance */ define "Guidance": case when "Client is due for the bOPV birth dose" then "Client is due for the bOPV birth dose Guidance" when "Client is not due for the bOPV birth dose" then "Client is not due for the bOPV birth dose 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 }
Value set Poliovirus-containing vaccines
IMMZ.D2.DT.Polio.Birth dose Birth dose administration as part of "bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (in countries that are poliomyelitis (polio)-endemic countries or at high risk of importation and subsequent spread of polio that follow the combined bOPV–IPV schedule)
WHO recommendations for routine immunization - summary tables (January 2025)
In polio-endemic countries and in countries at high risk of importation and subsequent spread of polio, WHO recommends a bOPV birth dose (zero dose) followed by the primary series of 3 bOPV doses and 2 IPV doses. The zero dose of bOPV should be administered at birth, or within the first week of life, to maximize seroconversion rates following subsequent doses and to induce mucosal protection before enteric pathogens may interfere with the immune response. Additionally, a birth dose of bOPV administered while infants are still protected by maternally-derived antibodies (up to 6 months) may prevent vaccine-associated paralytic polio (VAPP).
Determine if the client is due for a poliovirus vaccination according to the national immunization schedule
Determine if the client is due for a poliovirus vaccination according to the national immunization schedule Birth dose administration as part of "bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (in countries that are poliomyelitis (polio)-endemic countries or at high risk of importation and subsequent spread of polio that follow the combined bOPV–IPV schedule)
Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE30', display: 'Oral polio vaccines' } }, display: 'Oral polio vaccines' }
Check for Guidance for the patient regarding IMMZ.D2.DT.Polio.Birth dose.
Show Guidance for the patient regarding IMMZ.D2.DT.Polio.Birth dose.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }