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="IMMZD2DTRubellaLowIncidence"/>
<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;">IMMZD2DTRubellaLowIncidence</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD2DTRubellaLowIncidence.html">IMMZ.D2.DT.Rubella.Low incidence</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.Rubella.Low incidence</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.Rubella.Low incidence
Countries with low incidence of rubella</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-IMMZD2DTRubellaLowIncidenceLogic.html">IMMZD2DTRubellaLowIncidenceLogic</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 Rubella.:</b> Determine if the client is due for Rubella vaccine according to the national immunization protocol.
Countries with low incidence of rubella
<br/>
<b>If:</b>
<i>Applicability:</i>
Client is due for rubella vaccination
<i>(Client is due for rubella 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: 'DE17', display: 'Rubella-containing vaccines' } }, display: 'Rubella-containing vaccines' })</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Check for Guidance for the patient regarding IMMZ.D2.DT.Rubella.Low incidence.:</b> Show Guidance for the patient regarding IMMZ.D2.DT.Rubella.Low incidence.
<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="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Current Patient Age In Months"/>
</extension>
<extension url="statement">
<valueString
value="/**
* @dataElement Patient age in months
*/
define "Current Patient Age In Months":
AgeInMonthsAt(Today)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Client's age is less than 12 months"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is less than 12 months
@pseudocode: Today's date − "Date of birth" < 12 months
@code: Client's age is less than 12 months-42
@decision: IMMZ.D2.DT.Rubella.Low incidence: Countries with low incidence of rubella
*/
define "Client's age is less than 12 months":
Encounter."Current Patient Age In Months" < 12"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for rubella vaccination Case 1"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for rubella vaccination Case 1
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for rubella vaccination Case 1":
Encounter."Client's age is less than 12 months""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<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="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</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":
Elements."Doses Administered to Patient" I
where I.occurrence.toInterval() same day or before Today"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Rubella Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Rubella containing Doses Administered to Patient
*/
define "Rubella Doses Administered to Patient":
Encounter."Doses Administered to Patient" I
where
I.vaccineCode in Concepts."Rubella-containing vaccines""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Rubella Primary Series Doses Administered to Patient"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Rubella containing Doses Administered to Patient that are in the Primary series
*/
define "Rubella Primary Series Doses Administered to Patient":
"Rubella Doses Administered to Patient".seriesPrimary()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Number of Rubella Primary Series Doses Administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@internal: Number of Rubella Primary Series doses
*/
define "Number of Rubella Primary Series Doses Administered":
Count("Rubella Primary Series Doses Administered to Patient")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="No rubella primary series dose was administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No rubella primary series dose was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Rubella-containing vaccines" and "Type of dose" = "Primary series") = 0
@code: No rubella primary series dose was administered-127
@decision: IMMZ.D2.DT.Rubella.High incidence: Countries with high incidence and mortality from rubella
@decision: IMMZ.D2.DT.Rubella.Low incidence: Countries with low incidence of rubella
*/
define "No rubella primary series dose was administered":
"Number of Rubella Primary Series Doses Administered" = 0"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Client's age is more than or equal to 12 months"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Client's age is more than or equal to 12 months
@pseudocode: Today's date − "Date of birth" ≥ 12 months
@code: Client's age is more than or equal to 12 months-42
@decision: IMMZ.D2.DT.Rubella.Low incidence: Countries with low incidence of rubella
*/
define "Client's age is more than or equal to 12 months":
Encounter."Current Patient Age In Months" >= 12"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZElements"/>
</extension>
<extension url="name">
<valueString value="Live Attenuated Vaccines"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: Live attenuated vaccines
*/
define "Live Attenuated Vaccines":
"Doses Administered to Patient" I
where I.vaccineCode in Concepts."Live Attenuated""/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Live Attenuated Vaccines"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement Live attenuated vaccines
*/
define "Live Attenuated Vaccines":
Elements."Live Attenuated Vaccines" I
where I.occurrence.toInterval() same day or before Today"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString value="Date of Latest Live Attenuated Vaccine"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement Date and time of last live attenuated vaccine
*/
define "Date of Latest Live Attenuated Vaccine":
date from start of "Live Attenuated Vaccines".mostRecent().occurrence.toInterval()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Live vaccine was administered in the last 4 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Live vaccine was administered in the last 4 weeks
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) < 4 weeks
*/
define "Live vaccine was administered in the last 4 weeks":
"Date of Latest Live Attenuated Vaccine" is not null
and duration in weeks between "Date of Latest Live Attenuated Vaccine" and Today < 4"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="Live vaccine was administered in the last the 4 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: Live vaccine was administered in the last the 4 weeks
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) < 4 weeks
@code: Live vaccine was administered in the last the 4 weeks-92
@decision: IMMZ.D2.DT.Rubella.Low incidence: Countries with low incidence of rubella
*/
define "Live vaccine was administered in the last the 4 weeks":
Encounter."Live vaccine was administered in the last 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for rubella vaccination Case 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for rubella vaccination Case 2
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for rubella vaccination Case 2":
Encounter."No rubella primary series dose was administered"
and Encounter."Client's age is more than or equal to 12 months"
and Encounter."Live vaccine was administered in the last the 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</extension>
<extension url="name">
<valueString value="Client is not due for rubella vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for rubella vaccination
@pseudocode: "Immunization recommendation status" = "Not due"
*/
define "Client is not due for rubella vaccination":
"Client is not due for rubella vaccination Case 1"
or "Client is not due for rubella vaccination Case 2""/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is not due for rubella vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is not due for rubella vaccination Guidance
@guidance = Should not vaccinate client with rubella dose.
Check for any vaccines due and inform the caregiver of when to come back for the first dose.
@guidance = Should not vaccinate client with rubella dose as live vaccine was administered in the last 4 weeks.
Check for any other vaccines due.
*/
define "Client is not due for rubella vaccination Guidance":
case
when "Client is not due for rubella vaccination Case 1" then 'Should not vaccinate client with rubella dose.
Check for any vaccines due and inform the caregiver of when to come back for the first dose.'
when "Client is not due for rubella vaccination Case 2" then 'Should not vaccinate client with rubella dose as live vaccine was administered in the last 4 weeks.
Check for any other vaccines due.'
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="No live vaccine was administered in the last 4 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No live vaccine was administered in the last 4 weeks
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) ≥ 4 weeks
*/
define "No live vaccine was administered in the last 4 weeks":
not("Live vaccine was administered in the last 4 weeks")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="No live vaccine was administered in the last 4 weeks"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: No live vaccine was administered in the last 4 weeks
@pseudocode: Today's date − latest "Date and time of vaccination" (where "Live vaccine" = TRUE) ≥ 4 weeks
@code: No live vaccine was administered in the last 4 weeks-92
@decision: IMMZ.D2.DT.Rubella.High incidence: Countries with high incidence and mortality from rubella
@decision: IMMZ.D2.DT.Rubella.Low incidence: Countries with low incidence of rubella
*/
define "No live vaccine was administered in the last 4 weeks":
Encounter."No live vaccine was administered in the last 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</extension>
<extension url="name">
<valueString value="Client is due for rubella vaccination"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for rubella vaccination
@pseudocode: "Immunization recommendation status" = "Due"
*/
define "Client is due for rubella vaccination":
Encounter."No rubella primary series dose was administered"
and Encounter."Client's age is more than or equal to 12 months"
and Encounter."No live vaccine was administered in the last 4 weeks""/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</extension>
<extension url="name">
<valueString
value="Client is due for rubella vaccination Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Client is due for rubella vaccination Guidance
@guidance: Should vaccinate client with rubella dose as no rubella doses were administered, client is within appropriate age range and no live vaccine was administered in the last 4 weeks.
Check for contraindications.
*/
define "Client is due for rubella vaccination Guidance":
'Should vaccinate client with rubella dose as no rubella doses were administered, client is within appropriate age range and no live vaccine was administered in the last 4 weeks.
Check for contraindications.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaEncounterElements"/>
</extension>
<extension url="name">
<valueString
value="One rubella primary series dose was administered"/>
</extension>
<extension url="statement">
<valueString
value="/*
@input: One rubella primary series dose was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Rubella-containing vaccines" and "Type of dose" = "Primary series") = 1
@code: One rubella primary series dose was administered-127
@decision: IMMZ.D2.DT.Rubella.High incidence: Countries with high incidence and mortality from rubella
@decision: IMMZ.D2.DT.Rubella.Low incidence: Countries with low incidence of rubella
*/
define "One rubella primary series dose was administered":
"Number of Rubella Primary Series Doses Administered" = 1"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</extension>
<extension url="name">
<valueString value="Rubella immunization schedule is complete"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Rubella immunization schedule is complete
@pseudocode: "Immunization recommendation status" = "Complete"
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "Rubella-containing vaccines")
*/
define "Rubella immunization schedule is complete":
Encounter."One rubella primary series dose was administered""/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</extension>
<extension url="name">
<valueString
value="Rubella immunization schedule is complete Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@output: Rubella immunization schedule is complete Guidance
@guidance: Rubella immunization schedule is complete. One rubella primary series dose was administered.
Check for any other vaccines due.
*/
define "Rubella immunization schedule is complete Guidance":
'Rubella immunization schedule is complete. One rubella primary series dose was administered.
Check for any other vaccines due.'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</extension>
<extension url="name">
<valueString value="Guidance"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dynamicValue: Guidance
*/
define "Guidance":
case
when "Client is not due for rubella vaccination" then "Client is not due for rubella vaccination Guidance"
when "Client is due for rubella vaccination" then "Client is due for rubella vaccination Guidance"
when "Rubella immunization schedule is complete" then "Rubella immunization schedule is complete Guidance"
else ''
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="IMMZD2DTRubellaLowIncidenceLogic"/>
</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="26"/>
</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="27"/>
</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="28"/>
</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="29"/>
</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="30"/>
</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="31"/>
</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="32"/>
</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="33"/>
</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="34"/>
</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="35"/>
</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="36"/>
</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="37"/>
</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="38"/>
</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="39"/>
</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="40"/>
</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/IMMZD2DTRubellaEncounterElements"/>
</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="Library Common"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZCommon"/>
</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 Elements"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZElements"/>
</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 Concepts"/>
<resource
value="http://smart.who.int/immunizations/Library/IMMZConcepts"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Rubella-containing vaccines"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.DE17"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Live Attenuated"/>
<resource
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.LiveAttenuated"/>
</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="Has Guidance"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Client is due for rubella vaccination"/>
<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="protocolApplied"/>
<mustSupport value="occurrence"/>
<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="status"/>
<mustSupport value="isSubpotent"/>
<mustSupport value="vaccineCode"/>
<mustSupport value="protocolApplied"/>
<mustSupport value="occurrence"/>
<codeFilter>
<path value="status"/>
<code>
<code value="completed"/>
</code>
</codeFilter>
<codeFilter>
<path value="vaccineCode"/>
<valueSet
value="http://smart.who.int/immunizations/ValueSet/IMMZ.Z.LiveAttenuated"/>
</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="occurrence"/>
<mustSupport value="vaccineCode"/>
<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.DE17"/>
</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/IMMZD2DTRubellaLowIncidence"/>
<version value="1.0.0"/>
<name value="IMMZD2DTRubellaLowIncidence"/>
<title value="IMMZ.D2.DT.Rubella.Low incidence"/>
<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.Rubella.Low incidence
Countries with low incidence of rubella"/>
<relatedArtifact>
<type value="citation"/>
<citation
value="WHO recommendations for routine immunization - summary tables (January 2025)"/>
</relatedArtifact>
<library
value="http://smart.who.int/immunizations/Library/IMMZD2DTRubellaLowIncidenceLogic"/>
<action>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
<valueMarkdown
value="The first dose of rubella-containing vaccine can be delivered at 12 months of age."/>
</extension>
<title value="Determine if the client is due for Rubella."/>
<description
value="Determine if the client is due for Rubella vaccine according to the national immunization protocol.
Countries with low incidence of rubella"/>
<condition>
<kind value="applicability"/>
<expression>
<description value="Client is due for rubella vaccination"/>
<language value="text/cql-identifier"/>
<expression value="Client is due for rubella 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: 'DE17', display: 'Rubella-containing vaccines' } }, display: 'Rubella-containing vaccines' }"/>
</expression>
</dynamicValue>
</action>
<action>
<title
value="Check for Guidance for the patient regarding IMMZ.D2.DT.Rubella.Low incidence."/>
<description
value="Show Guidance for the patient regarding IMMZ.D2.DT.Rubella.Low incidence."/>
<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>