Id: IMMZD5DTMumpsContraindications Url: IMMZ.D5.DT.Mumps contraindications Version: 1.0.0 Title: IMMZ.D5.DT.Mumps contraindications 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.D5.DT.Mumps contraindications IMMZ.D5.DT.Mumps contraindications Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD5DTMumpsContraindicationsLogic Actions: Check for contraindications before administering the vaccine(s) due: Contraindication for Mumps immunization If: Applicability: Mumps vaccination is contraindicated (Mumps vaccination is contraindicated) Then: Definition: IMMZD5DTMR Dynamic Values: id: (Draft Medication Request ID for Mumps dose) medication: (Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE11', display: 'Mumps-containing vaccines' } }, display: 'Mumps-containing vaccines' }) Check for Guidance for the patient regarding IMMZ.D5.DT.Mumps contraindications.: Show Guidance for the patient regarding IMMZ.D5.DT.Mumps contraindications. 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' })
/* @internal: Potential contraindications observations */ define "Potential contraindications": ([Observation: Concepts."Potential contraindications"]).complete()
/* @internal: Observation for currently pregnant */ define "CI Currently pregnant Observation": "Potential contraindications" O where O.value ~ Concepts."CI-Currently pregnant"
/* @internal: Observation for currently pregnant */ define "CI Currently pregnant Observation": Elements."CI Currently pregnant Observation" O where O.encounter.references(EncounterId) or O.effective.toInterval() starts same day or after Today - 9 months
/* @internal: Condition for currently pregnant */ define "CI Currently pregnant Condition": [Condition: Concepts."CI-Currently pregnant"]
/* @internal: Condition for currently pregnant */ define "CI Currently pregnant Condition": Elements."CI Currently pregnant Condition" C where C.prevalenceInterval() includes Today
define "Pregnancy Status Observation": [Observation: Concepts."Pregnancy status"] O where O.status in { 'final', 'amended', 'corrected' }
define "Pregnant Observation": "Pregnancy Status Observation" O where O.value ~ Concepts."Pregnant"
define "Pregnant Observation": Elements."Pregnant Observation" O where O.encounter.references(EncounterId) or O.effective.toInterval() starts same day or after AsOf - 9 months
/* @input: The client is pregnant @pseudocode: "Potential contraindications" = "Currently pregnant" */ define "The client is pregnant": exists "CI Currently pregnant Observation" or exists "CI Currently pregnant Condition" or exists WE."Pregnant Observation"
/* @input: The client is currently pregnant @pseudocode: "Potential contraindications" = "Currently pregnant" @code: The client is currently pregnant-52 @decision: IMMZ.D5.DT.Mumps contraindications */ define "The client is currently pregnant": Encounter."The client is pregnant"
Mumps vaccination is contraindicated Case 1
/* @output: Mumps vaccination is contraindicated Case 1 @pseudocode: "Immunization recommendation status" = "Contraindicated" */ define "Mumps vaccination is contraindicated Case 1": Encounter."The client is currently pregnant"
CI Immunodeficiency syndromes Observation
/* @internal: Observation for Immunodeficiency syndromes */ define "CI Immunodeficiency syndromes Observation": "Potential contraindications" O where O.value ~ Concepts."CI-Immunodeficiency syndromes"
/* @internal: Observation for Immunodeficiency syndromes */ define "CI Immunodeficiency syndromes Observation": Elements."CI Immunodeficiency syndromes Observation".encounterOrOnBefore(EncounterId, Today)
/* @internal: Condition for Immunodeficiency syndromes */ define "CI Immunodeficiency syndromes Condition": [Condition: Concepts."CI-Immunodeficiency syndromes"]
/* @internal: Condition for Immunodeficiency syndromes */ define "CI Immunodeficiency syndromes Condition": Elements."CI Immunodeficiency syndromes Condition" C where C.prevalenceInterval() includes Today
The client has immunodeficiency syndromes
/* @input: The client has immunodeficiency syndromes @pseudocode: "Potential contraindications" = "Immunodeficiency syndromes" */ define "The client has immunodeficiency syndromes": exists "CI Immunodeficiency syndromes Observation" or exists "CI Immunodeficiency syndromes Condition"
/* @input: The client has immune deficiency @pseudocode: "Potential contraindications" = "Immunodeficiency syndromes" @code: The client has immune deficiency-60 @decision: IMMZ.D5.DT.Mumps contraindications */ define "The client has immune deficiency": Encounter."The client has immunodeficiency syndromes"
Mumps vaccination is contraindicated Case 2
/* @output: Mumps vaccination is contraindicated Case 2 @pseudocode: "Immunization recommendation status" = "Contraindicated" */ define "Mumps vaccination is contraindicated Case 2": Encounter."The client has immune deficiency"
CI Severely immunosuppressed Observation
/* @internal: Observation for Severely immunosuppressed */ define "CI Severely immunosuppressed Observation": "Potential contraindications" O where O.value ~ Concepts."CI-Severely immunosuppressed"
/* @internal: Observation for Severely immunosuppressed */ define "CI Severely immunosuppressed Observation": Elements."CI Severely immunosuppressed Observation".encounterOrOnBefore(EncounterId, Today)
/* @internal: Condition for Severely immunosuppressed */ define "CI Severely immunosuppressed Condition": [Condition: Concepts."CI-Severely immunosuppressed"]
/* @internal: Condition for Severely immunosuppressed */ define "CI Severely immunosuppressed Condition": Elements."CI Severely immunosuppressed Condition" C where C.prevalenceInterval() includes Today
/* @input: The client is severely immunosuppressed @pseudocode: "Potential contraindications" = "Severely immunosuppressed" */ define "The client is severely immunosuppressed": exists "CI Severely immunosuppressed Observation" or exists "CI Severely immunosuppressed Condition"
/* @input: The client is severely immunosuppressed @pseudocode: "Potential contraindications" = "Severely immunosuppressed" @code: The client is severely immunosuppressed-59 @decision: IMMZ.D5.DT.Mumps contraindications */ define "The client is severely immunosuppressed": Encounter."The client is severely immunosuppressed"
Mumps vaccination is contraindicated Case 3
/* @output: Mumps vaccination is contraindicated Case 3 @pseudocode: "Immunization recommendation status" = "Contraindicated" */ define "Mumps vaccination is contraindicated Case 3": Encounter."The client is severely immunosuppressed"
/* @output: Mumps vaccination is contraindicated @pseudocode: "Immunization recommendation status" = "Contraindicated" */ define "Mumps vaccination is contraindicated": "Mumps vaccination is contraindicated Case 1" or "Mumps vaccination is contraindicated Case 2" or "Mumps vaccination is contraindicated Case 3"
Mumps vaccination is contraindicated Guidance
/* @output: Mumps vaccination is contraindicated Guidance @guidance = Do not vaccinate client with mumps as mumps vaccination is contraindicated for pregnant individuals. @guidance = Do not vaccinate client with mumps as mumps vaccination is contraindicated in individuals with immunodeficiency syndromes. @guidance = Do not vaccinate client with mumps as mumps vaccination is contraindicated in immunosuppressed individuals. */ define "Mumps vaccination is contraindicated Guidance": case when "Mumps vaccination is contraindicated Case 1" then 'Do not vaccinate client with mumps as mumps vaccination is contraindicated for pregnant individuals.' when "Mumps vaccination is contraindicated Case 2" then 'Do not vaccinate client with mumps as mumps vaccination is contraindicated in individuals with immunodeficiency syndromes.' when "Mumps vaccination is contraindicated Case 3" then 'Do not vaccinate client with mumps as mumps vaccination is contraindicated in immunosuppressed individuals.' else '' end
CI Severe allergic reactions Observation
/* @internal: Observation for Severe allergic reactions */ define "CI Severe allergic reactions Observation": "Potential contraindications" O where O.value ~ Concepts."CI-Severe allergic reactions"
/* @internal: Observation for Severe allergic reactions */ define "CI Severe allergic reactions Observation": Elements."CI Severe allergic reactions Observation".encounterOrOnBefore(EncounterId, Today)
/* @internal: Condition for Severe allergic reactions */ define "CI Severe allergic reactions Condition": [Condition: Concepts."CI-Severe allergic reactions"]
/* @internal: Condition for Severe allergic reactions */ define "CI Severe allergic reactions Condition": Elements."CI Severe allergic reactions Condition" C where C.prevalenceInterval() includes Today
The client has history of severe allergic reactions
/* @input: The client has history of severe allergic reactions @pseudocode: "Potential contraindications" = "Severe allergic reactions" */ define "The client has history of severe allergic reactions": exists "CI Severe allergic reactions Observation" or exists "CI Severe allergic reactions Condition"
The client has allergy to vaccine components
/* @input: The client has allergy to vaccine components @pseudocode: '"Potential contraindications" = "Severe allergic reactions" @code: The client has allergy to vaccine components-60 @decision: IMMZ.D5.DT.Mumps contraindications */ define "The client has allergy to vaccine components": Encounter."The client has history of severe allergic reactions"
Mumps vaccination could be contraindicated. Clinical judgement is required.
/* @output: Mumps vaccination could be contraindicated. Clinical judgement is required. @pseudocode: Create a clinical note. Immunization recommendation status = "Further evaluation needed" */ define "Mumps vaccination could be contraindicated. Clinical judgement is required.": Encounter."The client has allergy to vaccine components"
Mumps vaccination could be contraindicated. Clinical judgement is required. Guidance
/* @output: Mumps vaccination could be contraindicated. Clinical judgement is required. Guidance @guidance: Do not vaccinate client with mumps if client has allergy to vaccine components, such as neomycin and gelatin. */ define "Mumps vaccination could be contraindicated. Clinical judgement is required. Guidance": 'Do not vaccinate client with mumps if client has allergy to vaccine components, such as neomycin and gelatin.'
/* @dynamicValue: Guidance */ define "Guidance": case when "Mumps vaccination is contraindicated" then "Mumps vaccination is contraindicated Guidance" when "Mumps vaccination could be contraindicated. Clinical judgement is required." then "Mumps vaccination could be contraindicated. Clinical judgement is required. Guidance" else '' end
define "Has Guidance": "Guidance" is not null and "Guidance" != ''
/* @dataElement: Draft Medication Request for Patient */ define "Draft Medication Request for Patient": [MedicationRequest] MR where MR.status = 'draft' and MR.intent = 'proposal' sort by date from (authoredOn as FHIR.dateTime) desc
/* @dataElement: Draft Medication Request for Patient */ define "Draft Medication Request for Patient": Elements."Draft Medication Request for Patient" MR where MR.encounter.references(EncounterId) or MR.authoredOn.toInterval() same day or before Today sort by date from (authoredOn as FHIR.dateTime) desc
/* @internal: Draft Medication Request for Mumps dose */ define "Draft Medication Request for Mumps dose": Encounter."Draft Medication Request for Patient" MR where MR.medication in Concepts."Mumps-containing vaccines"
Draft Medication Request ID for Mumps dose
/* @dynamicValue: Draft Medication Request ID for Mumps dose */ define "Draft Medication Request ID for Mumps dose": First(Encounter."Draft Medication Request for Mumps dose").id
define fluent function complete(observations List<Observation>): observations O where O.status in { 'final', 'amended', 'corrected' }
define function ToString(value ObservationStatus): value.value
define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }
/* @description: Returns true if the given reference is to the given resourceId @comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference. NOTE: This function assumes resources from the same source server. */ define fluent function references(reference FHIR.Reference, resourceId String): resourceId = Last(Split(reference.reference, '/'))
define function ToString(value string): 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
/* @description: Returns an interval representing the normalized prevalence period of a given Condition resource. @comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from onset to abatement as specified in the given Condition. */ define fluent function prevalenceInterval(condition Condition): if condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" then Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()] else (end of condition.abatementInterval()) abatementDate return if abatementDate is null then Interval[start of condition.onset.toInterval(), abatementDate) else Interval[start of condition.onset.toInterval(), abatementDate]
// Was getting error on this for this particular choice set not being found /* @description: Returns an interval representing the normalized Abatement of a given Condition resource. @comment: NOTE: Due to the complexity of determining an interval from a String, this function will throw a run-time exception if used with a Condition instance that has a String as the abatement value. */ define fluent function abatementInterval(condition Condition): if condition.abatement is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)] else if condition.abatement is FHIR.Period then FHIRHelpers.ToInterval(condition.abatement as FHIR.Period) else if condition.abatement 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 if condition.abatement is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year) else if condition.abatement is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year) else if condition.abatement is FHIR.boolean then Interval[end of condition.onset.toInterval(), condition.recordedDate) else null
/** * @description: Gets observation from an encounter or on or before a date */ define fluent function encounterOrOnBefore(observations List<Observation>, EncounterId String, beforeDate Date): observations O where (O.encounter.references(EncounterId) or O.effective.toInterval() starts same day or before beforeDate)
define function ToString(value MedicationRequestStatus): value.value
define function ToString(value MedicationRequestIntent): value.value
Code system ConditionClinicalStatusCodes
IMMZ.D5.DT.Mumps contraindications IMMZ.D5.DT.Mumps contraindications
WHO recommendations for routine immunization - summary tables (January 2025)
Check for contraindications before administering the vaccine(s) due
Concept { codes: { Code { system: 'http://smart.who.int/immunizations/CodeSystem/IMMZ.Z', code: 'DE11', display: 'Mumps-containing vaccines' } }, display: 'Mumps-containing vaccines' }
Check for Guidance for the patient regarding IMMZ.D5.DT.Mumps contraindications.
Show Guidance for the patient regarding IMMZ.D5.DT.Mumps contraindications.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }