Id: IMMZD2DTTBEFSMEImmun Url: IMMZ.D2.DT.TBE.FSME-Immun Version: 1.0.0 Title: IMMZ.D2.DT.TBE.FSME-Immun 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.TBE.FSME-Immun FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD2DTTBEFSMEImmunLogic Actions: Determine if the client is due for TBE.: Determine if the client is due for TBE vaccine according to the national immunization protocol. FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) If: Applicability: Client is due for TBE vaccination (Client is due for TBE vaccination) Then: Definition: IMMZD2DTMR Dynamic Values: status: ('draft') intent: ('proposal') medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE20', display: 'TBE vaccines' } }, display: 'TBE vaccines' }) Determine if the client is due for TBE.: Determine if the client is due for TBE vaccine according to the national immunization protocol. FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) If: Applicability: Primary series is complete. Client is due for TBE booster dose (Primary series is complete. Client is due for TBE booster dose) Then: Definition: IMMZD2DTMR Dynamic Values: status: ('draft') intent: ('proposal') medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE20', display: 'TBE vaccines' } }, display: 'TBE vaccines' }) Check for Guidance for the patient regarding IMMZ.D2.DT.TBE.FSME-Immun.: Show Guidance for the patient regarding IMMZ.D2.DT.TBE.FSME-Immun. 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 Patient age in years */ define "Current Patient Age In Years": AgeInYearsAt(Today)
/* @input: Client's age is less than 1 year @pseudocode: Today's date − "Date of birth" < 1 year @code: Client's age is less than 1 year-39 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "Client's age is less than 1 year": Encounter."Current Patient Age In Years" < 1
Client is not due for TBE vaccination Case 1
/* @output: Client is not due for TBE vaccination Case 1 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for TBE vaccination Case 1": Encounter."Client's age is less than 1 year"
/** * @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: TBE containing Doses Administered to Patient */ define "TBE Doses Administered to Patient": Encounter."Doses Administered to Patient" I where I.vaccineCode in Concepts."TBE vaccines"
TBE Primary Series Doses Administered to Patient
/* @internal: TBE containing Doses Administered to Patient that are in the Primary series */ define "TBE Primary Series Doses Administered to Patient": "TBE Doses Administered to Patient".seriesPrimary()
Number of TBE Primary Series Doses Administered
/* @internal: Number of TBE Primary Series doses */ define "Number of TBE Primary Series Doses Administered": Count("TBE Primary Series Doses Administered to Patient")
One TBE primary series dose was administered
/* @input: One TBE primary series dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "TBE vaccines" and "Type of dose" = "Primary series") = 1 @code: One TBE primary series dose was administered-112 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.TBE-Moscow: TBE-Moscow schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.EnceVir: EnceVir schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "One TBE primary series dose was administered": "Number of TBE Primary Series Doses Administered" = 1
/* @internal: Date of Latest TBE Dose */ define "Date of Latest TBE Dose": date from start of "TBE Doses Administered to Patient".mostRecent().occurrence.toInterval()
The latest TBE dose was administered less than 1 month ago
/* @input: The latest TBE dose was administered less than 1 month ago @pseudocode: Today's date − "Date and time of vaccination" (where "Vaccine type" = "TBE vaccines") < 1 month @code: The latest TBE dose was administered less than 1 month ago-95 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.TBE-Moscow: TBE-Moscow schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "The latest TBE dose was administered less than 1 month ago": "Date of Latest TBE Dose" is not null and duration in months between "Date of Latest TBE Dose" and Today < 1
Client is not due for TBE vaccination Case 2
/* @output: Client is not due for TBE vaccination Case 2 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for TBE vaccination Case 2": Encounter."One TBE primary series dose was administered" and Encounter."The latest TBE dose was administered less than 1 month ago"
Two TBE primary series doses were administered
/* @input: Two TBE primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "TBE vaccines" and "Type of dose" = "Primary series") = 2 @code: Two TBE primary series doses were administered-112 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.TBE-Moscow: TBE-Moscow schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.EnceVir: EnceVir schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "Two TBE primary series doses were administered": "Number of TBE Primary Series Doses Administered" = 2
The latest TBE dose was administered less than 5 months ago
/* @input: The latest TBE dose was administered less than 5 months ago @pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "TBE vaccines") < 5 months @code: The latest TBE dose was administered less than 5 months ago-103 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.EnceVir: EnceVir schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "The latest TBE dose was administered less than 5 months ago": "Date of Latest TBE Dose" is not null and duration in months between "Date of Latest TBE Dose" and Today < 5
Client is not due for TBE vaccination Case 3
/* @output: Client is not due for TBE vaccination Case 3 @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for TBE vaccination Case 3": Encounter."Two TBE primary series doses were administered" and Encounter."The latest TBE dose was administered less than 5 months ago"
/* @output: Client is not due for TBE vaccination @pseudocode: "Immunization recommendation status" = "Not due" */ define "Client is not due for TBE vaccination": "Client is not due for TBE vaccination Case 1" or "Client is not due for TBE vaccination Case 2" or "Client is not due for TBE vaccination Case 3"
Client is not due for TBE vaccination Guidance
/* @output: Client is not due for TBE vaccination Guidance @guidance = Should not vaccinate client with first TBE dose as client's age is less than 1 year. Check for any vaccines due and inform the caregiver of when to come back for the first dose. @guidance = Should not vaccinate client with second TBE dose as the latest dose was administered less than 1 month ago. Check for any vaccines due and inform the caregiver of when to come back for the next dose @guidance = Should not vaccinate client with third TBE dose as the latest dose was administered less than 5 months ago. Check for any vaccines due and inform the caregiver of when to come back for the next dose. */ define "Client is not due for TBE vaccination Guidance": case when "Client is not due for TBE vaccination Case 1" then 'Should not vaccinate client with first TBE dose as client\'s age is less than 1 year. Check for any vaccines due and inform the caregiver of when to come back for the first dose.' when "Client is not due for TBE vaccination Case 2" then 'Should not vaccinate client with second TBE dose as the latest dose was administered less than 1 month ago. Check for any vaccines due and inform the caregiver of when to come back for the next dose' when "Client is not due for TBE vaccination Case 3" then 'Should not vaccinate client with third TBE dose as the latest dose was administered less than 5 months ago. Check for any vaccines due and inform the caregiver of when to come back for the next dose.' else '' end
No TBE primary series doses were administered
/* @input: No TBE primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "TBE vaccines" and "Type of dose" = "Primary series") = 0 @code: No TBE primary series doses were administered-112 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.TBE-Moscow: TBE-Moscow schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.EnceVir: EnceVir schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "No TBE primary series doses were administered": "Number of TBE Primary Series Doses Administered" = 0
Client's age is more than or equal to 1 year
/* @input: Client's age is more than or equal to 1 year @pseudocode: Today's date − "Date of birth" ≥ 1 year @code: Client's age is more than or equal to 1 year-39 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "Client's age is more than or equal to 1 year": Encounter."Current Patient Age In Years" >= 1
Client is due for TBE vaccination Case 1
/* @output: Client is due for TBE vaccination Case 1 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for TBE vaccination Case 1": Encounter."No TBE primary series doses were administered" and Encounter."Client's age is more than or equal to 1 year"
The latest TBE dose was administered more than 1 month ago
/* @input: The latest TBE dose was administered more than 1 month ago @pseudocode: Today's date − "Date and time of vaccination" (where "Vaccine type" = "TBE vaccines") ≥ 1 month @code: The latest TBE dose was administered more than 1 month ago-95 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.TBE-Moscow: TBE-Moscow schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "The latest TBE dose was administered more than 1 month ago": not "The latest TBE dose was administered less than 1 month ago"
Client is due for TBE vaccination Case 2
/* @output: Client is due for TBE vaccination Case 2 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for TBE vaccination Case 2": Encounter."One TBE primary series dose was administered" and Encounter."The latest TBE dose was administered more than 1 month ago"
The latest TBE dose was administered more than 5 months ago
/* @input: The latest TBE dose was administered more than 5 months ago @pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "TBE vaccines") ≥ 5 months @code: The latest TBE dose was administered more than 5 months ago-103 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.EnceVir: EnceVir schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "The latest TBE dose was administered more than 5 months ago": not "The latest TBE dose was administered less than 5 months ago"
Client is due for TBE vaccination Case 3
/* @output: Client is due for TBE vaccination Case 3 @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for TBE vaccination Case 3": Encounter."Two TBE primary series doses were administered" and Encounter."The latest TBE dose was administered more than 5 months ago"
/* @output: Client is due for TBE vaccination @pseudocode: "Immunization recommendation status" = "Due" */ define "Client is due for TBE vaccination": "Client is due for TBE vaccination Case 1" or "Client is due for TBE vaccination Case 2" or "Client is due for TBE vaccination Case 3"
Client is due for TBE vaccination Guidance
/* @output: Client is due for TBE vaccination Guidance @guidance = Should vaccinate client with first TBE dose as no TBE doses have been administered and client's age is more than 1 year. Check for contraindications. @guidance = Should vaccinate client with second TBE dose as the latest dose was administered more than 1 month ago. Check for contraindications. @guidance = Should vaccinate client with third TBE dose as the latest dose was administered more than 5 months ago. Check for contraindications. */ define "Client is due for TBE vaccination Guidance": case when "Client is due for TBE vaccination Case 1" then 'Should vaccinate client with first TBE dose as no TBE doses have been administered and client\'s age is more than 1 year. Check for contraindications.' when "Client is due for TBE vaccination Case 2" then 'Should vaccinate client with second TBE dose as the latest dose was administered more than 1 month ago. Check for contraindications.' when "Client is due for TBE vaccination Case 3" then 'Should vaccinate client with third TBE dose as the latest dose was administered more than 5 months ago. Check for contraindications.' else '' end
Three TBE primary series doses were administered
/* @input: Three TBE primary series doses were administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "TBE vaccines" and "Type of dose" = "Primary series") = 3 @code: Three TBE primary series doses were administered-112 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.TBE-Moscow: TBE-Moscow schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.EnceVir: EnceVir schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "Three TBE primary series doses were administered": "Number of TBE Primary Series Doses Administered" = 3
TBE Booster Series Doses Administered to Patient
/* @internal: TBE Booster Series Doses Administered to Patient */ define "TBE Booster Series Doses Administered to Patient": "TBE Doses Administered to Patient".seriesBooster()
Number of TBE Booster Series Doses Administered
/* @internal: Number of TBE Booster Series Doses Administered */ define "Number of TBE Booster Series Doses Administered": Count("TBE Booster Series Doses Administered to Patient")
/* @input: No TBE booster dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "TBE vaccines" and "Type of dose" = "Booster dose") = 0 @code: No TBE booster dose was administered-110 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "No TBE booster dose was administered": "Number of TBE Booster Series Doses Administered" = 0
The latest TBE dose was administered less than 3 years ago
/* @input: The latest TBE dose was administered less than 3 years ago @pseudocode: 'Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "TBE vaccines") < 3 years @code: The latest TBE dose was administered less than 3 years ago-103 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.TBE-Moscow: TBE-Moscow schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.EnceVir: EnceVir schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "The latest TBE dose was administered less than 3 years ago": "Date of Latest TBE Dose" is not null and duration in years between "Date of Latest TBE Dose" and Today < 3
Primary series is complete. Client is not due for TBE booster dose
/* @output: Primary series is complete. Client is not due for TBE booster dose @pseudocode: "Immunization recommendation status" = "Not due" "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "TBE vaccines") */ define "Primary series is complete. Client is not due for TBE booster dose": Encounter."Three TBE primary series doses were administered" and Encounter."No TBE booster dose was administered" and Encounter."The latest TBE dose was administered less than 3 years ago"
Primary series is complete. Client is not due for TBE booster dose Guidance
/* @output: Primary series is complete. Client is not due for TBE booster dose Guidance @guidance: Should not vaccinate client with TBE booster dose as the latest TBE dose was administered less than 3 years ago. Check for any vaccines due and inform the caregiver of when to come back for the booster dose */ define "Primary series is complete. Client is not due for TBE booster dose Guidance": 'Should not vaccinate client with TBE booster dose as the latest TBE dose was administered less than 3 years ago. Check for any vaccines due and inform the caregiver of when to come back for the booster dose'
The latest TBE dose was administered more than 3 years ago
/* @input: The latest TBE dose was administered more than 3 years ago @pseudocode: Today's date − latest "Date and time of vaccination" (where "Vaccine type" = "TBE vaccines") ≥ 3 years @code: The latest TBE dose was administered more than 3 years ago-102 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.TBE-Moscow: TBE-Moscow schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) @decision: IMMZ.D2.DT.TBE.EnceVir: EnceVir schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "The latest TBE dose was administered more than 3 years ago": not "The latest TBE dose was administered less than 3 years ago"
Primary series is complete. Client is due for TBE booster dose
/* @output: Primary series is complete. Client is due for TBE booster dose @pseudocode: "Immunization recommendation status" = "Due" "Completed the primary vaccination series" = TRUE (where "Vaccine type" = "TBE vaccines") */ define "Primary series is complete. Client is due for TBE booster dose": Encounter."Three TBE primary series doses were administered" and Encounter."No TBE booster dose was administered" and Encounter."The latest TBE dose was administered more than 3 years ago"
Primary series is complete. Client is due for TBE booster dose Guidance
/* @output: Primary series is complete. Client is due for TBE booster dose Guidance @guidance: Should vaccinate client with TBE booster dose as the latest TBE dose was administered more than 3 years ago. Check for contraindications. */ define "Primary series is complete. Client is due for TBE booster dose Guidance": 'Should vaccinate client with TBE booster dose as the latest TBE dose was administered more than 3 years ago. Check for contraindications.'
At least one booster dose was administered
/* @input: At least one booster dose was administered @pseudocode: Count of vaccines administered (where "Vaccine type" = "TBE vaccines" and "Type of dose" = "Booster dose") ≥ 1 @code: At least one booster dose was administered-110 @decision: IMMZ.D2.DT.TBE.FSME-Immun: FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children) @decision: IMMZ.D2.DT.TBE.Encepur: Encepur schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children ) */ define "At least one booster dose was administered": "Number of TBE Booster Series Doses Administered" >= 1
/* @output: Clinical judgement is required. @pseudocode: Create a clinical note "Immunization recommendation status" = "Further evaluation needed" */ define "Clinical judgement is required.": Encounter."Three TBE primary series doses were administered" and Encounter."At least one booster dose was administered"
Clinical judgement is required. Guidance
/* @output: Clinical judgement is required. Guidance @guidance: Assess if supplementary booster TBE dose(s) are necessary and create a clinical note. Check for any other vaccines due. */ define "Clinical judgement is required. Guidance": 'Assess if supplementary booster TBE dose(s) are necessary and create a clinical note. Check for any other vaccines due.'
/* @dynamicValue: Guidance */ define "Guidance": case when "Client is not due for TBE vaccination" then "Client is not due for TBE vaccination Guidance" when "Client is due for TBE vaccination" then "Client is due for TBE vaccination Guidance" when "Primary series is complete. Client is not due for TBE booster dose" then "Primary series is complete. Client is not due for TBE booster dose Guidance" when "Primary series is complete. Client is due for TBE booster dose" then "Primary series is complete. Client is due for TBE booster dose Guidance" when "Clinical judgement is required." then "Clinical judgement is required. 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() )
/** * @description: Gets the doses from the Booster series */ define fluent function seriesBooster(immunizations List<Immunization>): immunizations I where exists( I.protocolApplied pa where pa.series = 'Booster dose' )
IMMZ.D2.DT.TBE.FSME-Immun FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children)
WHO recommendations for routine immunization - summary tables (January 2025)
The vaccines manufactured in Austria and Germany (FSME-Immun and Encepur) can be given from > 1 year of age. For the vaccines manufactured in Austria and Germany (FSME-Immun and Encepur), an interval of 1–3 months is recommended between the first 2 doses.
Determine if the client is due for TBE vaccine according to the national immunization protocol. FSME-Immun schedule (In areas where the disease is highly endemic, implying that there is a high individual risk of infection, WHO recommends that vaccination be offered to all age groups, including children)
Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE20', display: 'TBE vaccines' } }, display: 'TBE vaccines' }
For both vaccines (FSME-Immun and Encepur), the manufacturers recommend a booster dose to be administered 3 years after completion of the primary series. Although there is a strong indication that the spacing of boosters could be expanded considerably from the intervals currently recommended by the manufacturers (every 3–5 years), the evidence is still insufficient for a definitive recommendation on the optimal frequency and number of booster doses.
Check for Guidance for the patient regarding IMMZ.D2.DT.TBE.FSME-Immun.
Show Guidance for the patient regarding IMMZ.D2.DT.TBE.FSME-Immun.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }