WHO Immunization Implementation Guide
1.0.0 - release
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
| Draft as of 2026-03-31 |
<PlanDefinition xmlns="http://hl7.org/fhir">
<id value="IMMZD2DTPolioSequentialIPVbOPV"/>
<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;">IMMZD2DTPolioSequentialIPVbOPV</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD2DTPolioSequentialIPVbOPV.html">IMMZ.D2.DT.Polio.Sequential IPV–bOPV</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.Polio.Sequential IPV–bOPV</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.Polio.Sequential IPV–bOPV
Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])</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-IMMZD2DTPolioSequentialIPVbOPVLogic.html">IMMZD2DTPolioSequentialIPVbOPVLogic</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 a poliovirus vaccination according to the national immunization schedule:</b> Determine if the client is due for a poliovirus vaccination according to the national immunization schedule
Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high
vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share
substantial population movement have a similarly high coverage])
<br/>
<b>If:</b>
<i>Applicability:</i>
Client is due for IPV vaccination
<i>(Client is due for IPV 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: 'DE31', display: 'Inactivated polio vaccines' } }, display: 'Inactivated polio vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Determine if the client is due for a poliovirus vaccination according to the national immunization schedule:</b> Determine if the client is due for a poliovirus vaccination according to the national immunization schedule
Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high
vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share
substantial population movement have a similarly high coverage])
<br/>
<b>If:</b>
<i>Applicability:</i>
Client is due for bOPV vaccination
<i>(Client is due for bOPV 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: 'DE30', display: 'Oral polio vaccines' } }, display: 'Oral polio vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Check for Guidance for the patient regarding IMMZ.D2.DT.Polio.Sequential IPV–bOPV.:</b> Show Guidance for the patient regarding IMMZ.D2.DT.Polio.Sequential IPV–bOPV.
<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="IMMZElements"/>
</extension>
<extension url="name">
<valueString value="Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @dataElement All Doses Administered to Patient
*/
define "Doses Administered to Patient":
[Immunization] I
where I.status = 'completed'
and I.isSubpotent is not true"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioElements"/>
</extension>
<extension url="name">
<valueString value="Polio Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@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""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioElements"/>
</extension>
<extension url="name">
<valueString
value="Polio Primary Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Polio containing Doses Administered to Patient that are in the Primary series
*/
define "Polio Primary Series Doses Administered to Patient":
"Polio Doses Administered to Patient".seriesPrimary()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Polio Primary Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Polio containing Doses Administered to Patient that are in the Primary series
*/
define "Polio Primary Series Doses Administered to Patient":
PolioElements."Polio Primary Series Doses Administered to Patient".onOrBefore(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Number of Polio Primary Series Doses Administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Number of Polio Primary Series doses
*/
define "Number of Polio Primary Series Doses Administered":
Count("Polio Primary Series Doses Administered to Patient")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="No poliovirus primary series doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No poliovirus primary series doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Poliovirus-containing vaccines" and "Type of dose" = "Primary series") = 0
@code: No poliovirus primary series doses were administered-130
@decision: IMMZ.D2.DT.Polio.bOPV plus IPV: "Bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (applicable for all countries)
@decision: IMMZ.D2.DT.Polio.Sequential IPV–bOPV: Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])
@decision: IMMZ.D2.DT.Polio.IPV-only: Inactivated polio vaccine (IPV)-only (in countries, in polio-free regions, with a very low risk of importation and sustained high routine immunization coverage (third dose of the diphtheria–tetanus–pertussis vaccine [DTP3] > 90%)
*/
define "No poliovirus primary series doses were administered":
"Number of Polio Primary Series Doses Administered" = 0"/>
</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="Current Patient Age In Weeks"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @dataElement Patient age in weeks
*/
define "Current Patient Age In Weeks":
AgeInWeeksAt(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Client's age is less than 8 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is less than 8 weeks
@pseudocode: Today's date − "Date of birth" < 8 weeks
@code: Client's age is less than 8 weeks-40
@decision: IMMZ.D2.DT.Polio.Sequential IPV–bOPV: Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])
*/
define "Client's age is less than 8 weeks":
Encounter."Current Patient Age In Weeks" < 8"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for IPV vaccination Case 1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for IPV vaccination Case 1
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for IPV vaccination Case 1":
Encounter."No poliovirus primary series doses were administered"
and Encounter."Client's age is less than 8 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="One poliovirus primary series dose was administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: One poliovirus primary series dose was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Poliovirus-containing vaccines" and "Type of dose" = "Primary series") = 1
@code: One poliovirus primary series dose was administered-130
@decision: IMMZ.D2.DT.Polio.bOPV plus IPV: "Bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (applicable for all countries)
@decision: IMMZ.D2.DT.Polio.Sequential IPV–bOPV: Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])
@decision: IMMZ.D2.DT.Polio.IPV-only: Inactivated polio vaccine (IPV)-only (in countries, in polio-free regions, with a very low risk of importation and sustained high routine immunization coverage (third dose of the diphtheria–tetanus–pertussis vaccine [DTP3] > 90%)
*/
define "One poliovirus primary series dose was administered":
"Number of Polio Primary Series Doses Administered" = 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Polio Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Polio containing Doses Administered to Patient
*/
define "Polio Doses Administered to Patient":
PolioElements."Polio Doses Administered to Patient".onOrBefore(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Date of Latest Polio Dose"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Date of Latest Polio Dose
*/
define "Date of Latest Polio Dose":
date from start of "Polio Doses Administered to Patient".mostRecent().occurrence.toInterval()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest poliovirus dose was administered less than 4 weeks ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest poliovirus dose was administered less than 4 weeks ago
@pseudocode: Today's date − Latest "Date and time of vaccination" (where "Vaccine type" = "Poliovirus-containing vaccines") < 4 weeks
@code: The latest poliovirus dose was administered less than 4 weeks ago-120
@decision: IMMZ.D2.DT.Polio.Sequential IPV–bOPV: Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])
@decision: IMMZ.D2.DT.Polio.IPV-only: Inactivated polio vaccine (IPV)-only (in countries, in polio-free regions, with a very low risk of importation and sustained high routine immunization coverage (third dose of the diphtheria–tetanus–pertussis vaccine [DTP3] > 90%)
*/
define "The latest poliovirus dose was administered less than 4 weeks ago":
"Date of Latest Polio Dose" is not null
and duration in weeks between "Date of Latest Polio Dose" and Today < 4"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for IPV vaccination Case 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for IPV vaccination Case 2
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for IPV vaccination Case 2":
Encounter."One poliovirus primary series dose was administered"
and Encounter."The latest poliovirus dose was administered less than 4 weeks ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for IPV vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for IPV vaccination
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for IPV vaccination":
"Client is not due for IPV vaccination Case 1"
or "Client is not due for IPV vaccination Case 2""/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for IPV vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for IPV vaccination Guidance
@guidance = Should not vaccinate client with first IPV dose as client's age is less than 8 weeks.
Check for any other vaccines due and inform the caregiver of when to come back for the first poliovirus dose.
@guidance = Should not vaccinate client with second IPV dose as the latest IPV 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 next dose.
*/
define "Client is not due for IPV vaccination Guidance":
case
when "Client is not due for IPV vaccination Case 1" then 'Should not vaccinate client with first IPV dose as client\'s age is less than 8 weeks.
Check for any other vaccines due and inform the caregiver of when to come back for the first poliovirus dose.'
when "Client is not due for IPV vaccination Case 2" then 'Should not vaccinate client with second IPV dose as the latest IPV 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 next dose.'
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Client's age is more than or equal to 8 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is more than or equal to 8 weeks
@pseudocode: Today's date − "Date of birth" ≥ 8 weeks
@code: Client's age is more than or equal to 8 weeks-40
@decision: IMMZ.D2.DT.Polio.Sequential IPV–bOPV: Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])
*/
define "Client's age is more than or equal to 8 weeks":
Encounter."Current Patient Age In Weeks" >= 8"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for IPV vaccination Case 1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for IPV vaccination Case 1
@pseudocode: "Immunization recommendation status" = "Due" (where "Type of poliovirus dose" = "IPV")
*/
define "Client is due for IPV vaccination Case 1":
Encounter."No poliovirus primary series doses were administered"
and Encounter."Client's age is more than or equal to 8 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="The latest poliovirus dose was administered more than 4 weeks ago"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: The latest poliovirus dose was administered more than 4 weeks ago
@pseudocode: Today's date − Latest "Date and time of vaccination" (where "Vaccine type" = "Poliovirus-containing vaccines") ≥ 4 weeks
@code: The latest poliovirus dose was administered more than 4 weeks ago-120
@decision: IMMZ.D2.DT.Polio.Sequential IPV–bOPV: Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])
@decision: IMMZ.D2.DT.Polio.IPV-only: Inactivated polio vaccine (IPV)-only (in countries, in polio-free regions, with a very low risk of importation and sustained high routine immunization coverage (third dose of the diphtheria–tetanus–pertussis vaccine [DTP3] > 90%)
*/
define "The latest poliovirus dose was administered more than 4 weeks ago":
not("The latest poliovirus dose was administered less than 4 weeks ago")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for IPV vaccination Case 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for IPV vaccination Case 2
@pseudocode: "Immunization recommendation status" = "Due" (where "Type of poliovirus dose" = "IPV")
*/
define "Client is due for IPV vaccination Case 2":
Encounter."One poliovirus primary series dose was administered"
and Encounter."The latest poliovirus dose was administered more than 4 weeks ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for IPV vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for IPV vaccination
@pseudocode: "Immunization recommendation status" = "Due" (where "Type of poliovirus dose" = "IPV")
*/
define "Client is due for IPV vaccination":
"Client is due for IPV vaccination Case 1"
or "Client is due for IPV vaccination Case 2""/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for IPV vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for IPV vaccination Guidance
@guidance = Should vaccinate client with first IPV dose as client is within appropriate age range and IPV dose was not administered.
Check for contraindications.
@guidance = Should vaccinate client with second IPV dose as the latest IPV dose was administered more than 4 weeks ago.
Check for contraindications.
*/
define "Client is due for IPV vaccination Guidance":
case
when "Client is due for IPV vaccination Case 1" then 'Should vaccinate client with first IPV dose as client is within appropriate age range and IPV dose was not administered.
Check for contraindications.'
when "Client is due for IPV vaccination Case 2" then 'Should vaccinate client with second IPV dose as the latest IPV dose was administered more than 4 weeks ago.
Check for contraindications.'
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Two poliovirus primary series doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Two poliovirus primary series doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Poliovirus-containing vaccines" and "Type of dose" = "Primary series") = 2
@code: Two poliovirus primary series doses were administered-130
@decision: IMMZ.D2.DT.Polio.bOPV plus IPV: "Bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (applicable for all countries)
@decision: IMMZ.D2.DT.Polio.Sequential IPV–bOPV: Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])
@decision: IMMZ.D2.DT.Polio.IPV-only: Inactivated polio vaccine (IPV)-only (in countries, in polio-free regions, with a very low risk of importation and sustained high routine immunization coverage (third dose of the diphtheria–tetanus–pertussis vaccine [DTP3] > 90%)
*/
define "Two poliovirus primary series doses were administered":
"Number of Polio Primary Series Doses Administered" = 2"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for bOPV vaccination Case 1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for bOPV vaccination Case 1
@pseudocode: "Immunization recommendation status" = "Due" (where "Type of poliovirus dose" = "bOPV")
*/
define "Client is due for bOPV vaccination Case 1":
Encounter."Two poliovirus primary series doses were administered""/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Three poliovirus primary series doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Three poliovirus primary series doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Poliovirus-containing vaccines" and "Type of dose" = "Primary series") = 3
@code: Three poliovirus primary series doses were administered-130
@decision: IMMZ.D2.DT.Polio.bOPV plus IPV: "Bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (applicable for all countries)
@decision: IMMZ.D2.DT.Polio.Sequential IPV–bOPV: Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])
@decision: IMMZ.D2.DT.Polio.IPV-only: Inactivated polio vaccine (IPV)-only (in countries, in polio-free regions, with a very low risk of importation and sustained high routine immunization coverage (third dose of the diphtheria–tetanus–pertussis vaccine [DTP3] > 90%)
*/
define "Three poliovirus primary series doses were administered":
"Number of Polio Primary Series Doses Administered" = 3"/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for bOPV vaccination Case 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for bOPV vaccination Case 2
@pseudocode: "Immunization recommendation status" = "Due" (where "Type of poliovirus dose" = "bOPV")
*/
define "Client is due for bOPV vaccination Case 2":
Encounter."Three poliovirus primary series doses were administered"
and Encounter."The latest poliovirus dose was administered more than 4 weeks ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for bOPV vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for bOPV vaccination
@pseudocode: "Immunization recommendation status" = "Due" (where "Type of poliovirus dose" = "bOPV")
*/
define "Client is due for bOPV vaccination":
"Client is due for bOPV vaccination Case 1"
or "Client is due for bOPV vaccination Case 2""/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for bOPV vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for bOPV vaccination Guidance
@guidance = Should vaccinate client with first bOPV dose as two IPV doses were administered.
Check for contraindications.
@guidance = Should vaccinate client with second bOPV dose as the latest bOPV dose was administered more than 4 weeks ago.
Check for contraindications.
*/
define "Client is due for bOPV vaccination Guidance":
case
when "Client is due for bOPV vaccination Case 1" then 'Should vaccinate client with first bOPV dose as two IPV doses were administered.
Check for contraindications.'
when "Client is due for bOPV vaccination Case 2" then 'Should vaccinate client with second bOPV dose as the latest bOPV dose was administered more than 4 weeks ago.
Check for contraindications.'
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for bOPV vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for bOPV vaccination
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for bOPV vaccination":
Encounter."Three poliovirus primary series doses were administered"
and Encounter."The latest poliovirus dose was administered less than 4 weeks ago""/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for bOPV vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for bOPV vaccination Guidance
@guidance: Should not vaccinate client with second bOPV dose as the latest bOPV 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 next dose
*/
define "Client is not due for bOPV vaccination Guidance":
'Should not vaccinate client with second bOPV dose as the latest bOPV 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 next dose'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Four poliovirus primary series doses were administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Four poliovirus primary series doses were administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Poliovirus-containing vaccines" and "Type of dose" = "Primary series") = 4
@code: Four poliovirus primary series doses were administered-130
@decision: IMMZ.D2.DT.Polio.bOPV plus IPV: "Bivalent oral polio vaccine (bOPV) plus inactivated polio vaccine (IPV)" schedule (applicable for all countries)
@decision: IMMZ.D2.DT.Polio.Sequential IPV–bOPV: Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])
*/
define "Four poliovirus primary series doses were administered":
"Number of Polio Primary Series Doses Administered" = 4"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Primary series is complete"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary series is complete
@pseudocode: "Immunization recommendation status" = "Further evaluation needed"
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Poliovirus-containing vaccines")
*/
define "Primary series is complete":
Encounter."Four poliovirus primary series doses were administered""/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Primary series is complete Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Primary series is complete Guidance
@guidance: Poliovirus primary series is complete. Assess if supplementary bOPV dose(s) are necessary and create a clinical note.
Check for any other vaccines due.
*/
define "Primary series is complete Guidance":
'Poliovirus primary series is complete. Assess if supplementary bOPV dose(s) are necessary and create a clinical note.
Check for any other vaccines due.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dynamicValue: Guidance
*/
define "Guidance":
case
when "Client is not due for IPV vaccination" then "Client is not due for IPV vaccination Guidance"
when "Client is due for IPV vaccination" then "Client is due for IPV vaccination Guidance"
when "Client is due for bOPV vaccination" then "Client is due for bOPV vaccination Guidance"
when "Client is not due for bOPV vaccination" then "Client is not due for bOPV vaccination Guidance"
when "Primary series is complete" then "Primary series is complete Guidance"
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTPolioSequentialIPVbOPVLogic"/>
</extension>
<extension url="name">
<valueString value="Has Guidance"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Guidance":
"Guidance" is not null and "Guidance" != ''"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZCommon"/>
</extension>
<extension url="name">
<valueString value="onOrBefore"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</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<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"/>
</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="ToDateTime"/>
</extension>
<extension url="statement">
<valueString
value="define function ToDateTime(value dateTime): value.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="ToInterval"/>
</extension>
<extension url="statement">
<valueString
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]"/>
</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="ToDateTime"/>
</extension>
<extension url="statement">
<valueString
value="define function ToDateTime(value instant): 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="ToDate"/>
</extension>
<extension url="statement">
<valueString
value="define function ToDate(value date): value.value"/>
</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="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: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')
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="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="42"/>
</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<Immunization>):
immunizations I where
exists( I.protocolApplied pa where pa.series = 'Primary series' )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="43"/>
</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="44"/>
</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="45"/>
</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="46"/>
</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="47"/>
</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="48"/>
</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<Immunization>):
Last(
immunizations I
sort by start of occurrence.toInterval()
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="49"/>
</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/IMMZD2DTPolioEncounterElements"/>
</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 WC"/>
<resource
value="http://smart.who.int/immunizations/Library/WHOCommon"/>
</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 PolioElements"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZD2DTPolioElements"/>
</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 Concepts"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZConcepts"/>
</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="Value set Poliovirus-containing vaccines"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE14"/>
</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="Client is due for bOPV vaccination"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Client is due for IPV vaccination"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Has Guidance"/>
<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="occurrence"/>
<mustSupport value="protocolApplied"/>
<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="vaccineCode"/>
<mustSupport value="occurrence"/>
<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.DE14"/>
</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/IMMZD2DTPolioSequentialIPVbOPV"/>
<version value="1.0.0"/>
<name value="IMMZD2DTPolioSequentialIPVbOPV"/>
<title value="IMMZ.D2.DT.Polio.Sequential IPV–bOPV"/>
<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.Polio.Sequential IPV–bOPV
Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share substantial population movement have a similarly high coverage])"/>
<relatedArtifact>
<type value="citation"/>
<citation
value="WHO recommendations for routine immunization - summary tables (January 2025)"/>
</relatedArtifact>
<library
value="http://smart.who.int/immunizations/Library/IMMZD2DTPolioSequentialIPVbOPVLogic"/>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="For sequential IPV– bOPV schedules, WHO recommends that the first dose of IPV be given starting from 8 weeks of
age with an interval of 4–8 weeks before administration of the second IPV dose. This should be followed by at least 2 doses
of bOPV separated by 4–8 weeks depending on the risk of exposure to poliovirus in early childhood. Where a sequential IPV–bOPV
schedule is used, the initial administration of 2 doses of IPV should be followed by ≥2 doses of bOPV to ensure sufficient
levels of protection in the intestinal mucosa as well as a decrease in the burden of vaccine-associated paralytic polio (VAPP)."/>
</extension>
<title
value="Determine if the client is due for a poliovirus vaccination according to the national immunization schedule"/>
<description
value="Determine if the client is due for a poliovirus vaccination according to the national immunization schedule
Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high
vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share
substantial population movement have a similarly high coverage])"/>
<condition>
<kind value="applicability"/>
<expression>
<description value="Client is due for IPV vaccination"/>
<language value="text/cql-identifier"/>
<expression value="Client is due for IPV 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: 'DE31', display: 'Inactivated polio vaccines' } }, display: 'Inactivated polio vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="For sequential IPV– bOPV schedules, WHO recommends that the first dose of IPV be given starting from 8 weeks of
age with an interval of 4–8 weeks before administration of the second IPV dose. This should be followed by at least 2 doses
of bOPV separated by 4–8 weeks depending on the risk of exposure to poliovirus in early childhood. Where a sequential IPV–bOPV
schedule is used, the initial administration of 2 doses of IPV should be followed by ≥2 doses of bOPV to ensure sufficient
levels of protection in the intestinal mucosa as well as a decrease in the burden of vaccine-associated paralytic polio (VAPP)."/>
</extension>
<title
value="Determine if the client is due for a poliovirus vaccination according to the national immunization schedule"/>
<description
value="Determine if the client is due for a poliovirus vaccination according to the national immunization schedule
Sequential "Bivalent oral polio vaccine (bOPV)–inactivated polio vaccine (IPV)" schedule (in countries with high
vaccination coverage [e.g. 90–95%] and low importation risk [where neighbouring countries and/or countries that share
substantial population movement have a similarly high coverage])"/>
<condition>
<kind value="applicability"/>
<expression>
<description value="Client is due for bOPV vaccination"/>
<language value="text/cql-identifier"/>
<expression value="Client is due for bOPV 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: 'DE30', display: 'Oral polio vaccines' } }, display: 'Oral polio vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<title
value="Check for Guidance for the patient regarding IMMZ.D2.DT.Polio.Sequential IPV–bOPV."/>
<description
value="Show Guidance for the patient regarding IMMZ.D2.DT.Polio.Sequential IPV–bOPV."/>
<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>