WHO Immunization Implementation Guide
0.2.0 - ci-build

WHO Immunization Implementation Guide, published by WHO. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-immunizations/ and changes regularly. See the Directory of published versions

Library: IMMZD18SDTPPregnant3Logic

Official URL: http://smart.who.int/immunizations/Library/IMMZD18SDTPPregnant3Logic Version: 0.2.0
Draft as of 2025-09-17 Computable Name: IMMZD18SDTPPregnant3Logic

This library defines decision support logic for the IMMZ.D18.S.DTP.Pregnancy starting with 3 doses schedule table in the Immunization CPG

Title: IMMZD18SDTPPregnant3Logic
Id: IMMZD18SDTPPregnant3Logic
Version: 0.2.0
Url: IMMZD18SDTPPregnant3Logic
Status: draft
Type:

system: http://terminology.hl7.org/CodeSystem/library-type

code: logic-library

Date: 2025-09-17 23:03:28+0000
Publisher: WHO
Description:

This library defines decision support logic for the IMMZ.D18.S.DTP.Pregnancy starting with 3 doses schedule table in the Immunization CPG

Related Artifacts:

Dependencies

Parameters:
NameTypeMinMaxIn/Out
Todaydate01In
PatientPatient01Out
First tetanus and diphtheria booster dose was administeredboolean01Out
Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy)boolean01Out
Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Due Datedate01Out
Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Overduedate01Out
Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Expirationstring01Out
Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Createstring01Out
Second tetanus and diphtheria booster dose was administeredboolean01Out
Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy)boolean01Out
Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Due Datedate01Out
Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Overduedate01Out
Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Expirationstring01Out
Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Createstring01Out
Third tetanus and diphtheria-containing booster dose was administered. Tetanus and diphtheria immunization schedule has been completedboolean01Out
Tetanus and diphtheria-containing vaccine booster dose 3boolean01Out
Tetanus and diphtheria-containing vaccine booster dose 3 Due Datedate01Out
Tetanus and diphtheria-containing vaccine booster dose 3 Createstring01Out
Tetanus and diphtheria-containing vaccine booster dose 3 OverdueResource01Out
Tetanus and diphtheria-containing vaccine booster dose 3 ExpirationResource01Out
Test ValidationResource01Out
Content: text/cql

/*
 * Library: IMMZD18SDTPPregnant3Logic (IMMZ.D18.S.DTP.Pregnancy starting with 3 doses schedule)
 * Schedule Table: Diphtheria and tetanus vaccination schedule in pregnant women who received 3 childhood diphtheria–tetanus–pertussis (DTP) doses
 */
library IMMZD18SDTPPregnant3Logic

using FHIR version '4.0.1'
include FHIRHelpers version '4.0.1'

include WHOCommon called WC

include IMMZCommon called Common
include IMMZConcepts called Concepts

include IMMZEncounterElements called IE
include IMMZD2DTDTPEncounterElements called Encounter

parameter Today Date default Today()

context Patient


/*
@output: Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy)
@description: Provision of tetanus and diphtheria booster dose 1 for pregnant women who received only 3 doses of DTP during childhood without booster doses
@trigger: The primary DTP series has been completed and client is currently pregnant
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "DTP-containing vaccines") AND "Currently pregnant" = TRUE
@triggerDate: "Contact date" WHEN "ANC contact number" = 1
*/
define "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy)":
  Encounter."Three DTP primary series doses were administered"
  and Encounter."Client is currently pregnant"
  and not("First tetanus and diphtheria booster dose was administered")

/*
@output: Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Create
@create: Pregnant women who have received only 3 doses of tetanus-containing vaccines during childhood without booster doses should receive 2 doses of tetanus-containing vaccines at the earliest opportunity during pregnancy with a minimal interval of 4 weeks between doses and the second dose at least 2 weeks before giving birth.
*/
define "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Create":
  if "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy)" 
  then 'Pregnant women who have received only 3 doses of tetanus-containing vaccines during childhood without booster doses should receive 2 doses of tetanus-containing vaccines at the earliest opportunity during pregnancy with a minimal interval of 4 weeks between doses and the second dose at least 2 weeks before giving birth.' + '
Due Date: ' + ToString("Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Due Date") + '
Overdue: ' + ToString("Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Overdue") + '
Expiration: ' + "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Expiration"
  else ''

/*
@dynamicValue: Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Due Date
@pseudocode: "Contact date" WHEN "ANC contact number" = 1
*/
define "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Due Date":
  if "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy)" then Today
  else null

/*
@dynamicValue: Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Overdue
@pseudocode: Every subsequent contact until 38 weeks
*/
define "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Overdue":
  if "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy)" then Today
  else null

/*
@dynamicValue: Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Expiration
@pseudocode: Two weeks before birth for the pregnancy; however, individuals remain eligible to be vaccinated.
"Gestational age" < 38 weeks
*/
define "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy) Expiration":
  if "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy)" then 'Two weeks before birth'
  else null
  
/*
@complete: First tetanus and diphtheria booster dose was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines" and "Type of dose" = "Booster dose") = 1
*/
define "First tetanus and diphtheria booster dose was administered":
  Encounter."One tetanus and diphtheria booster dose was administered"

/*
@output: Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy)
@description: Provision of tetanus and diphtheria booster dose 2 for pregnant women who received only 3 doses of DTP during childhood without booster doses
@trigger: First tetanus and diphtheria booster dose was administered 
Count of vaccines administered (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines" and "Type of dose" = "Booster dose") = 1
@triggerDate: Latest "Date and time of vaccination" where "Vaccine type" = "Tetanus and diphtheria-containing vaccines"
*/
define "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy)":
  "First tetanus and diphtheria booster dose was administered" and
  Encounter."Client is currently pregnant" and
  not "Second tetanus and diphtheria booster dose was administered"

/*
@output: Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Create
@create: Pregnant women who have received only 3 doses of tetanus-containing vaccines during childhood without booster doses should receive 2 doses of tetanus-containing vaccines at the earliest opportunity during pregnancy with a minimal interval of 4 weeks between doses and the second dose at least 2 weeks before giving birth.
*/
define "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Create":
  if "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy)" 
  then 'Pregnant women who have received only 3 doses of tetanus-containing vaccines during childhood without booster doses should receive 2 doses of tetanus-containing vaccines at the earliest opportunity during pregnancy with a minimal interval of 4 weeks between doses and the second dose at least 2 weeks before giving birth.' + '
Due Date: ' + ToString("Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Due Date") + '
Overdue: ' + ToString("Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Overdue") + '
Expiration: ' + "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Expiration"
  else ''

/*
@dynamicValue: Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Due Date
@pseudocode: Latest "Date and time of vaccination" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines") + 4 'week'
*/
define "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Due Date":
  if "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy)" then Encounter."Date of Latest Td Dose" + 4 weeks
  else null

/*
@dynamicValue: Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Overdue
@pseudocode: Every subsequent contact until 38 weeks
*/
define "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Overdue":
  if "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy)" then Encounter."Date of Latest Td Dose" + 4 weeks
  else null

/*
@dynamicValue: Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Expiration
@pseudocode: Two weeks before birth for the pregnancy; however, individuals remain eligible to be vaccinated after giving birth.
"Gestational age" < 38 weeks
*/
define "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy) Expiration":
  if "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy)" then 'Two weeks before birth'
  else null
  
/*
@complete: Second tetanus and diphtheria booster dose was administered
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines" and "Type of dose" = "Booster dose") = 2
*/
define "Second tetanus and diphtheria booster dose was administered":
  Encounter."Two tetanus and diphtheria booster doses were administered"

/*
@output: Tetanus and diphtheria-containing vaccine booster dose 3
@description: Provision of tetanus and diphtheria booster dose 3 for pregnant women who received only 3 doses of DTP during childhood without booster doses
@trigger: Second tetanus and diphtheria booster dose was administered 
Count of vaccines administered (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines" and "Type of dose" = "Booster dose") = 2
@triggerDate: Latest "Date and time of vaccination" where "Vaccine type" = "Tetanus and diphtheria-containing vaccines"
*/
define "Tetanus and diphtheria-containing vaccine booster dose 3":
  "Second tetanus and diphtheria booster dose was administered" and
  not "Third tetanus and diphtheria-containing booster dose was administered. Tetanus and diphtheria immunization schedule has been completed"

/*
@output: Tetanus and diphtheria-containing vaccine booster dose 3 Create
@create: A sixth dose would be needed at least 1 year after the fifth dose, or during the next pregnancy.
*/
define "Tetanus and diphtheria-containing vaccine booster dose 3 Create":
  if "Tetanus and diphtheria-containing vaccine booster dose 3" 
  then 'A sixth dose would be needed at least 1 year after the fifth dose, or during the next pregnancy.' + '
Due Date: ' + ToString("Tetanus and diphtheria-containing vaccine booster dose 3 Due Date")
  else ''

/*
@dynamicValue: Tetanus and diphtheria-containing vaccine booster dose 3 Due Date
@pseudocode: Latest "Date and time of vaccination" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines") + 1 year or during next pregnancy
*/
define "Tetanus and diphtheria-containing vaccine booster dose 3 Due Date":
  if "Tetanus and diphtheria-containing vaccine booster dose 3" then Encounter."Date of Latest Td Dose" + 1 year
  else null

/*
@dynamicValue: Tetanus and diphtheria-containing vaccine booster dose 3 Overdue
@pseudocode: To be determined by Member States
*/
define "Tetanus and diphtheria-containing vaccine booster dose 3 Overdue":
  null

/*
@dynamicValue: Tetanus and diphtheria-containing vaccine booster dose 3 Expiration
@pseudocode: To be determined by Member States. However, there is no recommended expiration date and individuals remain eligible to be vaccinated.
*/
define "Tetanus and diphtheria-containing vaccine booster dose 3 Expiration":
  null
  
/*
@complete: Third tetanus and diphtheria-containing booster dose was administered. Tetanus and diphtheria immunization schedule has been completed
@pseudocode: Count of vaccines administered (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines" and "Type of dose" = "Booster dose") = 3
*/
define "Third tetanus and diphtheria-containing booster dose was administered. Tetanus and diphtheria immunization schedule has been completed":
  Encounter."Three tetanus and diphtheria booster doses were administered"

/*
@test: Test expected results based on example patients
*/
define "Test Validation":
  case
    when Patient.id = '66.DTP3Td0PT' then "Tetanus and diphtheria-containing vaccine booster dose 1 (during pregnancy)"
    when Patient.id = '67.DTP3Td1PTTdlt4w' then "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy)"
    when Patient.id = '68.DTP3Td1PTTdgt4w' then "Tetanus and diphtheria-containing vaccine booster dose 2 (during pregnancy)"
    when Patient.id = '69.DTP3Td2PTTdlt1y' then "Tetanus and diphtheria-containing vaccine booster dose 3"
    when Patient.id = '70.DTP3Td2PTTdgt1y' then "Tetanus and diphtheria-containing vaccine booster dose 3"
    when Patient.id = '71.DTP3Td3' then "Third tetanus and diphtheria-containing booster dose was administered. Tetanus and diphtheria immunization schedule has been completed"
    else 'No test case set'
  end
Content: application/elm+xml
Encoded data (96428 characters)