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
| Draft as of 2025-09-17 |
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<div>\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">IMMZD18SDTPDelayed</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"PlanDefinition-IMMZD18SDTPDelayed.html\">IMMZ.D18.S.DTP.Delayed or interrupted schedule</a></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.2.0</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">IMMZ.D18.S.DTP.Delayed or interrupted schedule</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">draft</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <b>system: </b> <span><a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-plan-definition-type.html\">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>code: </b> <span>eca-rule</span>\n </p>\n \n \n \n \n \n </td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Date: </b></th>\n <td style=\"padding-left: 4px;\">2025-09-17 23:03:28+0000</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">WHO</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>IMMZ.D18.S.DTP.Delayed or interrupted schedule\nDiphtheria–tetanus–pertussis (DTP) vaccination schedule for the following groups: children ≥ 1 year of age with no previous immunization, adolescents and adults with no previous immunization (including pregnant women) and supplementary immunization activities in high-risk areas, for women of reproductive age</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Knowledge Capability: </b></th>\n <td style=\"padding-left: 4px;\">\n \n computable \n </td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Related Artifacts: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p><b>References</b></p>\n <ul>\n \n <li><div><p>WHO recommendations for routine immunization - summary tables (January 2025)</p>\n</div><br/><a href=\"null\"/></li>\n \n </ul>\n \n \n \n \n \n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-IMMZD18SDTPDelayedLogic.html\">IMMZD18SDTPDelayedLogic</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Actions: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td>\n \n <b> DTP dose 1 (delayed start):</b> Provision of DTP dose 1 with a delayed start\nTrigger event: No DTP doses were administered and client's age is more than 1 year \nCount of vaccines administered (where "Vaccine type" = "DTP-containing vaccines") = 0 AND Today's date − "Date of birth" > 1 year\nTrigger date: Date of birth\nCreate condition: For children whose vaccination series has been interrupted, the series should be resumed without repeating previous doses. Children aged 1 year to under 7 years who have not previously been vaccinated should receive 3 doses of vaccine following a 0, 1, 6 month schedule.\n\nIf tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong protection.\n\nPregnant women and their newborn infants are protected from birth-associated tetanus if the mother received 5 doses if first vaccinated during adolescence/adulthood.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n DTP dose 1 (delayed start)\n \n <i>(DTP dose 1 (delayed start))</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-IMMZD2DTCR.html\">IMMZ.D2.DT.CR</a><br/>\n \n <i>Dynamic Values:</i><br/>\n \n status: <i>('active')</i>\n <br/>\n \n payload.contentString: <i>(DTP dose 1 (delayed start) Create)</i>\n <br/>\n \n category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>\n <br/>\n \n priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>\n <br/>\n \n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> DTP dose 2 (delayed start):</b> Provision of DTP dose 2 with a delayed start\nTrigger event: First DTP dose from the primary series was administered \nCount of vaccines administered (where "Vaccine type" = "DTP-containing vaccines" and "Type of dose" = "Primary series") = 1\nTrigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines"\nCreate condition: For children whose vaccination series has been interrupted, the series should be resumed without repeating previous doses. Children aged 1 year to under 7 years who have not previously been vaccinated should receive 3 doses of vaccine following a 0, 1, 6 month schedule.\n\nIf tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong protection.\n\nPregnant women and their newborn infants are protected from birth-associated tetanus if the mother received 5 doses if first vaccinated during adolescence/adulthood.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n DTP dose 2 (delayed start)\n \n <i>(DTP dose 2 (delayed start))</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-IMMZD2DTCR.html\">IMMZ.D2.DT.CR</a><br/>\n \n <i>Dynamic Values:</i><br/>\n \n status: <i>('active')</i>\n <br/>\n \n payload.contentString: <i>(DTP dose 2 (delayed start) Create)</i>\n <br/>\n \n category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>\n <br/>\n \n priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>\n <br/>\n \n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> DTP dose 3 (delayed start):</b> Provision of DTP dose 3 with a delayed start\nTrigger event: Second DTP dose from the primary series was administered \nCount of vaccines administered (where "Vaccine type" = "DTP-containing vaccines" and "Type of dose" = "Primary series") = 2\nTrigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines"\nCreate condition: For children whose vaccination series has been interrupted, the series should be resumed without repeating previous doses. Children aged 1 year to under 7 years who have not previously been vaccinated should receive 3 doses of vaccine following a 0, 1, 6 month schedule.\n\nIf tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong protection.\n\nPregnant women and their newborn infants are protected from birth-associated tetanus if the mother received 5 doses if first vaccinated during adolescence/adulthood.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n DTP dose 3 (delayed start)\n \n <i>(DTP dose 3 (delayed start))</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-IMMZD2DTCR.html\">IMMZ.D2.DT.CR</a><br/>\n \n <i>Dynamic Values:</i><br/>\n \n status: <i>('active')</i>\n <br/>\n \n payload.contentString: <i>(DTP dose 3 (delayed start) Create)</i>\n <br/>\n \n category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>\n <br/>\n \n priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>\n <br/>\n \n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> Tetanus and diphtheria-containing vaccine booster dose 1 (delayed start):</b> Provision of tetanus and diphtheria booster dose 1\nTrigger event: The primary DTP series has been completed\n"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "DTP-containing vaccines")\nTrigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines"\nCreate condition: Two subsequent booster doses using tetanus toxoid with reduced diphteria toxoid (Td) or Td with acellular pertussis (TdaP) combination vaccines are needed with an interval of at least 1 year between doses.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n Tetanus and diphtheria-containing vaccine booster dose 1 (delayed start)\n \n <i>(Tetanus and diphtheria-containing vaccine booster dose 1 (delayed start))</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-IMMZD2DTCR.html\">IMMZ.D2.DT.CR</a><br/>\n \n <i>Dynamic Values:</i><br/>\n \n status: <i>('active')</i>\n <br/>\n \n payload.contentString: <i>(Tetanus and diphtheria-containing vaccine booster dose 1 (delayed start) Create)</i>\n <br/>\n \n category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>\n <br/>\n \n priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>\n <br/>\n \n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> Tetanus and diphtheria-containing vaccine booster dose 2 (delayed start):</b> Provision of tetanus and diphtheria booster dose 2\nTrigger event: First tetanus and diphtheria booster dose was administered \nCount of vaccines administered (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines" and "Type of dose" = "Booster dose") = 1\nTrigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines")\nCreate condition: Two subsequent booster doses using tetanus toxoid with reduced diphteria toxoid (Td) or Td with acellular pertussis (TdaP) combination vaccines are needed with an interval of at least 1 year between doses.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n Tetanus and diphtheria-containing vaccine booster dose 2 (delayed start)\n \n <i>(Tetanus and diphtheria-containing vaccine booster dose 2 (delayed start))</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-IMMZD2DTCR.html\">IMMZ.D2.DT.CR</a><br/>\n \n <i>Dynamic Values:</i><br/>\n \n status: <i>('active')</i>\n <br/>\n \n payload.contentString: <i>(Tetanus and diphtheria-containing vaccine booster dose 2 (delayed start) Create)</i>\n <br/>\n \n category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>\n <br/>\n \n priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>\n <br/>\n \n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> Pertussis-containing vaccine booster dose 1 (delayed start):</b> Provision of the pertussis-containing booster dose 1\nTrigger event: The primary DTP series has been completed and client's age is between 1 year and 6 years\n"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "DTP-containing vaccines") AND 1 year ≤ Today's date − "Date of birth" ≤ 6 years\nTrigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines")\nCreate condition: A booster dose is recommended for children aged 1–6 years, preferably during the second year of life (≥ 6 months after last primary dose).\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n Pertussis-containing vaccine booster dose 1 (delayed start)\n \n <i>(Pertussis-containing vaccine booster dose 1 (delayed start))</i>\n 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"expression" : {
"description" : "Alert priority",
"language" : "text/cql-expression",
"expression" : "Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }"
}
}
]
},
{
"title" : "Pertussis-containing vaccine booster dose 1 (delayed start)",
"description" : "Provision of the pertussis-containing booster dose 1\nTrigger event: The primary DTP series has been completed and client's age is between 1 year and 6 years\n\"Completed the primary vaccination series\" = TRUE (where \"Vaccine type\" = \"DTP-containing vaccines\") AND 1 year ≤ Today's date − \"Date of birth\" ≤ 6 years\nTrigger date: Latest \"Date and time of vaccination\" (where \"Vaccine type\" = \"DTP-containing vaccines\")\nCreate condition: A booster dose is recommended for children aged 1–6 years, preferably during the second year of life (≥ 6 months after last primary dose).",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"description" : "Pertussis-containing vaccine booster dose 1 (delayed start)",
"language" : "text/cql-identifier",
"expression" : "Pertussis-containing vaccine booster dose 1 (delayed start)"
}
}
],
"definitionCanonical" : "http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTCR",
"dynamicValue" : [
{
"path" : "status",
"expression" : {
"language" : "text/cql-expression",
"expression" : "'active'"
}
},
{
"path" : "payload.contentString",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Pertussis-containing vaccine booster dose 1 (delayed start) Create"
}
},
{
"path" : "category.coding",
"expression" : {
"description" : "Category of communication",
"language" : "text/cql-expression",
"expression" : "Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }"
}
},
{
"path" : "priority",
"expression" : {
"description" : "Alert priority",
"language" : "text/cql-expression",
"expression" : "Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }"
}
}
]
}
]
}