Id: IMMZD5DTTBEContraindications Url: IMMZ.D5.DT.TBE contraindications Version: 1.0.0 Title: IMMZ.D5.DT.TBE 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.TBE contraindications IMMZ.D5.DT.TBE contraindications Knowledge Capability: computable Related Artifacts: References WHO recommendations for routine immunization - summary tables (January 2025) Libraries: IMMZD5DTTBEContraindicationsLogic Actions: Check for Guidance for the patient regarding IMMZ.D5.DT.TBE contraindications.: Show Guidance for the patient regarding IMMZ.D5.DT.TBE 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.TBE contraindications */ define "The client is currently pregnant": Encounter."The client is pregnant"
Clinical judgement is required. Create a clinical note Case 1
/* @output: Clinical judgement is required. Create a clinical note Case 1 @pseudocode: "Immunization recommendation status" = "Further evaluation needed" */ define "Clinical judgement is required. Create a clinical note Case 1": Encounter."The client is currently pregnant"
/* @internal: Observation for Moderate to severe fever */ define "CI Moderate to severe fever Observation": "Potential contraindications" O where O.value ~ Concepts."CI-Moderate to severe fever"
/* @internal: Observation for Moderate to severe fever */ define "CI Moderate to severe fever Observation": Elements."CI Moderate to severe fever Observation".encounterOrOnBefore(EncounterId, Today)
/* @internal: Condition for Moderate to severe fever */ define "CI Moderate to severe fever Condition": [Condition: Concepts."CI-Moderate to severe fever"]
/* @internal: Condition for Moderate to severe fever */ define "CI Moderate to severe fever Condition": Elements."CI Moderate to severe fever Condition" C where C.prevalenceInterval() includes Today
/* @input: The client has moderate to severe fever @pseudocode: "Potential contraindications" = "Moderate to severe fever" */ define "The client has moderate to severe fever": exists "CI Moderate to severe fever Observation" or exists "CI Moderate to severe fever Condition"
/* @input: The client has moderate to severe fever @pseudocode: "Potential contraindications" = "Moderate to severe fever" @code: The client has moderate to severe fever-58 @decision: IMMZ.D5.DT.TBE contraindications */ define "The client has moderate to severe fever": Encounter."The client has moderate to severe fever"
Clinical judgement is required. Create a clinical note Case 2
/* @output: Clinical judgement is required. Create a clinical note Case 2 @pseudocode: "Immunization recommendation status" = "Further evaluation needed" */ define "Clinical judgement is required. Create a clinical note Case 2": Encounter."The client has moderate to severe fever"
Clinical judgement is required. Create a clinical note
/* @output: Clinical judgement is required. Create a clinical note @pseudocode: "Immunization recommendation status" = "Further evaluation needed" */ define "Clinical judgement is required. Create a clinical note": "Clinical judgement is required. Create a clinical note Case 1" or "Clinical judgement is required. Create a clinical note Case 2"
Clinical judgement is required. Create a clinical note Guidance
/* @output: Clinical judgement is required. Create a clinical note Guidance @guidance = Conduct a risk–benefit assessment considering the incidence of the disease, consider risks of vaccination and make a clinical judgement. @guidance = Consider postponing the vaccination if the client has fever > 38.5°C or other signs of serious disease. Consider risks of vaccination and make a clinical judgement. */ define "Clinical judgement is required. Create a clinical note Guidance": case when "Clinical judgement is required. Create a clinical note Case 1" then 'Conduct a risk–benefit assessment considering the incidence of the disease, consider risks of vaccination and make a clinical judgement.' when "Clinical judgement is required. Create a clinical note Case 2" then 'Consider postponing the vaccination if the client has fever > 38.5°C or other signs of serious disease. Consider risks of vaccination and make a clinical judgement.' else '' end
/* @dynamicValue: Guidance */ define "Guidance": case when "Clinical judgement is required. Create a clinical note" then "Clinical judgement is required. Create a clinical note Guidance" else '' end
define "Has Guidance": "Guidance" is not null and "Guidance" != ''
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)
Code system ConditionClinicalStatusCodes
IMMZ.D5.DT.TBE contraindications IMMZ.D5.DT.TBE contraindications
WHO recommendations for routine immunization - summary tables (January 2025)
Check for Guidance for the patient regarding IMMZ.D5.DT.TBE contraindications.
Show Guidance for the patient regarding IMMZ.D5.DT.TBE contraindications.
Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }
Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }