Id: IMMZD2DTRabies Url: IMMZ.D2.DT.Rabies Version: 1.0.0 Title: IMMZ.D2.DT.Rabies 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.Rabies Pre-exposure prophylaxis (PrEP), 2-dose scheme; high risk of rabies virus exposure Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD2DTRabiesLogic Actions: Determine if the client is due for Rabies.: Determine if the client is due for Rabies vaccine according to the national immunization protocol. Pre-exposure prophylaxis (PrEP), 2-dose scheme; high risk of rabies virus exposure If: Applicability: Client is due for rabies vaccination (Client is due for rabies vaccination) Then: Definition: IMMZD2DTMR Dynamic Values: status: ('draft') intent: ('proposal') medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE15', display: 'Rabies vaccines' } }, display: 'Rabies vaccines' }) Check for Guidance for the patient regarding IMMZ.D2.DT.Rabies.: Show Guidance for the patient regarding IMMZ.D2.DT.Rabies. 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
/** * @dataElement All Doses Administered to Patient */ define "Doses Administered to Patient": Elements."Doses Administered to Patient" I where I.occurrence.toInterval() same day or before Today
/* @internal: Rabies containing Doses Administered to Patient */ define "Rabies Doses Administered to Patient": Encounter."Doses Administered to Patient" I where I.vaccineCode in Concepts."Rabies vaccines"
Rabies Primary Series Doses Administered to Patient
/* @internal: Rabies containing Doses Administered to Patient that are in the Primary series */ define "Rabies Primary Series Doses Administered to Patient": "Rabies Doses Administered to Patient".seriesPrimary()
Number of Rabies Primary Series Doses Administered
/* @internal: Number of Rabies Primary Series doses */ define "Number of Rabies Primary Series Doses Administered": Count("Rabies Primary Series Doses Administered to Patient")
No rabies primary series doses were administered
/* @input: No rabies primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Rabies vaccines" and "Type of dose" = "Primary series") = 0 @code: No rabies primary series doses were administered-115 @decision: IMMZ.D2.DT.Rabies: Pre-exposure prophylaxis (PrEP), 2-dose scheme; high risk of rabies virus exposure */ define "No rabies primary series doses were administered": "Number of Rabies Primary Series Doses Administered" = 0
Client is due for rabies vaccination Case 1
/* @output: Client is due for rabies vaccination Case 1 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for rabies vaccination Case 1": Encounter."No rabies primary series doses were administered"
One rabies primary series doses were administered
/* @input: One rabies primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Rabies vaccines" and "Type of dose" = "Primary series") = 1 @code: One rabies primary series doses were administered-115 @decision: IMMZ.D2.DT.Rabies: Pre-exposure prophylaxis (PrEP), 2-dose scheme; high risk of rabies virus exposure */ define "One rabies primary series doses were administered": "Number of Rabies Primary Series Doses Administered" = 1
/* @internal: Date of Latest Rabies Dose */ define "Date of Latest Rabies Dose": date from start of "Rabies Doses Administered to Patient".mostRecent().occurrence.toInterval()
The latest rabies dose was administered less than 7 days ago
/* @input: The latest rabies dose was administered less than 7 days ago @pseudocode: ''Today's date - Latest "Date of vaccination" (where "Vaccine type" = "Rabies vaccines") < 7 days @code: The latest rabies dose was administered less than 7 days ago-97 @decision: IMMZ.D2.DT.Rabies: Pre-exposure prophylaxis (PrEP), 2-dose scheme; high risk of rabies virus exposure */ define "The latest rabies dose was administered less than 7 days ago": "Date of Latest Rabies Dose" is not null and duration in days between "Date of Latest Rabies Dose" and Today < 7
The latest rabies dose was administered more than 7 days ago
/* @input: The latest rabies dose was administered more than 7 days ago @pseudocode: ''Today's date - Latest "Date of vaccination" (where "Vaccine type" = "Rabies vaccines") ≥ 7 days @code: The latest rabies dose was administered more than 7 days ago-97 @decision: IMMZ.D2.DT.Rabies: Pre-exposure prophylaxis (PrEP), 2-dose scheme; high risk of rabies virus exposure */ define "The latest rabies dose was administered more than 7 days ago": not "The latest rabies dose was administered less than 7 days ago"
Client is due for rabies vaccination Case 2
/* @output: Client is due for rabies vaccination Case 2 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for rabies vaccination Case 2": Encounter."One rabies primary series doses were administered" and Encounter."The latest rabies dose was administered more than 7 days ago"
/* @output: Client is due for rabies vaccination @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for rabies vaccination": "Client is due for rabies vaccination Case 1" or "Client is due for rabies vaccination Case 2"
Client is due for rabies vaccination Guidance
/* @output: Client is due for rabies vaccination Guidance @guidance = Should vaccinate client with first rabies dose as no rabies doses were administered and client is at high risk of exposure. Check for contraindications. @guidance = Should vaccinate client with second rabies dose as the latest rabies dose was administerd 7 or more days ago. Check for contraindications. */ define "Client is due for rabies vaccination Guidance": case when "Client is due for rabies vaccination Case 1" then 'Should vaccinate client with first rabies dose as no rabies doses were administered and client is at high risk of exposure. Check for contraindications.' when "Client is due for rabies vaccination Case 2" then 'Should vaccinate client with second rabies dose as the latest rabies dose was administerd 7 or more days ago. Check for contraindications.' else '' end
Client is not due for rabies vaccination
/* @output: Client is not due for rabies vaccination @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for rabies vaccination": Encounter."One rabies primary series doses were administered" and Encounter."The latest rabies dose was administered less than 7 days ago"
Client is not due for rabies vaccination Guidance
/* @output: Client is not due for rabies vaccination Guidance @guidance: Should not vaccinate client with second rabies dose as the latest rabies dose was administered less than 7 days ago. Check for any other vaccines due and inform the caregiver of when to come back for the second dose. */ define "Client is not due for rabies vaccination Guidance": 'Should not vaccinate client with second rabies dose as the latest rabies dose was administered less than 7 days ago. Check for any other vaccines due and inform the caregiver of when to come back for the second dose.'
Two rabies primary series doses were administered
/* @input: Two rabies primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "Rabies vaccines" and "Type of dose" = "Primary series") = 2 @code: Two rabies primary series doses were administered-115 @decision: IMMZ.D2.DT.Rabies: Pre-exposure prophylaxis (PrEP), 2-dose scheme; high risk of rabies virus exposure */ define "Two rabies primary series doses were administered": "Number of Rabies Primary Series Doses Administered" = 2
Rabies immunization schedule is complete
/* @output: Rabies immunization schedule is complete @pseudocode: "Immunization recommendation status" = "Complete" "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Rabies vaccines") */ define "Rabies immunization schedule is complete": Encounter."Two rabies primary series doses were administered"
Rabies immunization schedule is complete Guidance
/* @output: Rabies immunization schedule is complete Guidance @guidance: Rabies immunization schedule is complete. Two rabies primary series doses were administered. Check for any other vaccines due. */ define "Rabies immunization schedule is complete Guidance": 'Rabies immunization schedule is complete. Two rabies primary series doses were administered. Check for any other vaccines due.'
/* @dynamicValue: Guidance */ define "Guidance": case when "Client is due for rabies vaccination" then "Client is due for rabies vaccination Guidance" when "Client is not due for rabies vaccination" then "Client is not due for rabies vaccination Guidance" when "Rabies immunization schedule is complete" then "Rabies immunization schedule is complete Guidance" else '' end
define "Has Guidance": "Guidance" is not null and "Guidance" != ''
/** * @description: Gets the doses from the primary series */ define fluent function seriesPrimary(immunizations List<Immunization>): immunizations I where exists( I.protocolApplied pa where pa.series = 'Primary series' )
define function ToString(value string): value.value
define function ToString(value ImmunizationStatus): value.value
define function ToBoolean(value boolean): value.value
/* From FHIRCommon 4.1.0: */ /* @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval @comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible representations for timing-valued elements in FHIR, allowing this function to be used across any resource. The input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range. The intent of this function is to provide a clear and concise mechanism to treat single elements that have multiple possible representations as intervals so that logic doesn't have to account for the variability. More complex calculations (such as medication request period or dispense period calculation) need specific guidance and consideration. That guidance may make use of this function, but the focus of this function is on single element calculations where the semantics are unambiguous. If the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime. If the input is a Period, the result is a DateTime Interval. If the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing. If the input is an instant, the result is a DateTime Interval beginning and ending on that instant. If the input is a string, an error is raised indicating a single interval cannot be computed from a string. If the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age, and ending immediately prior to when the patient was the given Age plus one year. If the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given by the low end of the Range, and ending immediately prior to when the patient was the Age given by the high end of the Range plus one year. NOTE: Due to the complexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used with a Timing or String. */ define fluent function toInterval(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>): case when choice is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)] when choice is FHIR.Period then FHIRHelpers.ToInterval(choice as FHIR.Period) when choice is FHIR.instant then Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)] when choice is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year) when choice is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year) when choice is FHIR.Timing then Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') when choice is FHIR.string then Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported') else null as Interval<DateTime> end
define function ToDateTime(value dateTime): value.value
define function ToInterval(period FHIR.Period): if period is null then null else if period."start" is null then Interval(period."start".value, period."end".value] else Interval[period."start".value, period."end".value]
define function ToDateTime(value instant): value.value
define function ToDate(value date): value.value
define function ToQuantity(quantity FHIR.Quantity): case when quantity is null then null when quantity.value is null then null when quantity.comparator is not null then Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.') when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org' or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) } else Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')') end
define function ToCalendarUnit(unit System.String): case unit when 'ms' then 'millisecond' when 's' then 'second' when 'min' then 'minute' when 'h' then 'hour' when 'd' then 'day' when 'wk' then 'week' when 'mo' then 'month' when 'a' then 'year' else unit end
define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }
define fluent function mostRecent(immunizations List<Immunization>): Last( immunizations I sort by start of occurrence.toInterval() )
IMMZ.D2.DT.Rabies Pre-exposure prophylaxis (PrEP), 2-dose scheme; high risk of rabies virus exposure
WHO recommendations for routine immunization - summary tables (January 2025)
The schedule is for a 2-site intradermal vaccine administered on days 0 and 7. If intramuscular administration is used, WHO recommends a 1-site intramuscular vaccine administration on days 0 and 7. Note: This PrEP dose is recommended for individuals at high risk of rabies virus exposure. These include subpopulations in highly endemic settings with limited access to timely and adequate PrEP, individuals at occupational risk and travellers who may be at risk of exposure. WHO recommendations apply only to inactivated modern, concentrated, purified cell culture and embryonated egg-based rabies vaccines (CCEEVs). PrEP schedule: 2-site intradermal vaccine administered on days 0 and 7. If intramuscular administration is used, WHO recommends a 1-site intramuscular vaccine administration on days 0 and 7. If any doses are delayed, vaccination should be resumed, not restarted. A change in the route of administration or in vaccine product during a course is acceptable if such a change is unavoidable. The schedule is for a 2-site intradermal vaccine administered on days 0 and 7. If intramuscular administration is used, WHO recommends a 1-site intramuscular vaccine administration on days 0 and 7.
Determine if the client is due for Rabies.
Determine if the client is due for Rabies vaccine according to the national immunization protocol. Pre-exposure prophylaxis (PrEP), 2-dose scheme; high risk of rabies virus exposure
Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE15', display: 'Rabies vaccines' } }, display: 'Rabies vaccines' }
Check for Guidance for the patient regarding IMMZ.D2.DT.Rabies.
Show Guidance for the patient regarding IMMZ.D2.DT.Rabies.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }