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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<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">IMMZD18SDTPDelayed</td>
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<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD18SDTPDelayed.html">IMMZ.D18.S.DTP.Delayed or interrupted schedule</a></td>
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<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.2.0</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">IMMZ.D18.S.DTP.Delayed or interrupted schedule</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
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<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<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>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>eca-rule</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2025-09-17 23:03:28+0000</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">WHO</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>IMMZ.D18.S.DTP.Delayed or interrupted schedule
Diphtheria–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>
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<tr>
<th scope="row"><b>Knowledge Capability: </b></th>
<td style="padding-left: 4px;">
computable
</td>
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<tr>
<th scope="row"><b>Related Artifacts: </b></th>
<td style="padding-left: 4px;">
<p><b>References</b></p>
<ul>
<li><div><p>WHO recommendations for routine immunization - summary tables (January 2025)</p>
</div><br/><a href="null"/></li>
</ul>
</td>
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<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-IMMZD18SDTPDelayedLogic.html">IMMZD18SDTPDelayedLogic</a></td>
</tr>
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<tr>
<th scope="row"><b>Actions: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td>
<b> DTP dose 1 (delayed start):</b> Provision of DTP dose 1 with a delayed start
Trigger event: No DTP doses were administered and client's age is more than 1 year
Count of vaccines administered (where "Vaccine type" = "DTP-containing vaccines") = 0 AND Today's date − "Date of birth" > 1 year
Trigger date: Date of birth
Create 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.
If tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong protection.
Pregnant women and their newborn infants are protected from birth-associated tetanus if the mother received 5 doses if first vaccinated during adolescence/adulthood.
<br/>
<b>If:</b>
<i>Applicability:</i>
DTP dose 1 (delayed start)
<i>(DTP dose 1 (delayed start))</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTCR.html">IMMZ.D2.DT.CR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('active')</i>
<br/>
payload.contentString: <i>(DTP dose 1 (delayed start) Create)</i>
<br/>
category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>
<br/>
priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>
<br/>
</td>
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<tr>
<td>
<b> DTP dose 2 (delayed start):</b> Provision of DTP dose 2 with a delayed start
Trigger event: First DTP dose from the primary series was administered
Count of vaccines administered (where "Vaccine type" = "DTP-containing vaccines" and "Type of dose" = "Primary series") = 1
Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines"
Create 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.
If tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong protection.
Pregnant women and their newborn infants are protected from birth-associated tetanus if the mother received 5 doses if first vaccinated during adolescence/adulthood.
<br/>
<b>If:</b>
<i>Applicability:</i>
DTP dose 2 (delayed start)
<i>(DTP dose 2 (delayed start))</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTCR.html">IMMZ.D2.DT.CR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('active')</i>
<br/>
payload.contentString: <i>(DTP dose 2 (delayed start) Create)</i>
<br/>
category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>
<br/>
priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>
<br/>
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<tr>
<td>
<b> DTP dose 3 (delayed start):</b> Provision of DTP dose 3 with a delayed start
Trigger event: Second DTP dose from the primary series was administered
Count of vaccines administered (where "Vaccine type" = "DTP-containing vaccines" and "Type of dose" = "Primary series") = 2
Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines"
Create 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.
If tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong protection.
Pregnant women and their newborn infants are protected from birth-associated tetanus if the mother received 5 doses if first vaccinated during adolescence/adulthood.
<br/>
<b>If:</b>
<i>Applicability:</i>
DTP dose 3 (delayed start)
<i>(DTP dose 3 (delayed start))</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTCR.html">IMMZ.D2.DT.CR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('active')</i>
<br/>
payload.contentString: <i>(DTP dose 3 (delayed start) Create)</i>
<br/>
category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>
<br/>
priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>
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<tr>
<td>
<b> Tetanus and diphtheria-containing vaccine booster dose 1 (delayed start):</b> Provision of tetanus and diphtheria booster dose 1
Trigger event: The primary DTP series has been completed
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "DTP-containing vaccines")
Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines"
Create 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.
<br/>
<b>If:</b>
<i>Applicability:</i>
Tetanus and diphtheria-containing vaccine booster dose 1 (delayed start)
<i>(Tetanus and diphtheria-containing vaccine booster dose 1 (delayed start))</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTCR.html">IMMZ.D2.DT.CR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('active')</i>
<br/>
payload.contentString: <i>(Tetanus and diphtheria-containing vaccine booster dose 1 (delayed start) Create)</i>
<br/>
category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>
<br/>
priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>
<br/>
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<tr>
<td>
<b> Tetanus and diphtheria-containing vaccine booster dose 2 (delayed start):</b> Provision of tetanus and diphtheria booster dose 2
Trigger event: 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
Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "Tetanus and diphtheria-containing vaccines")
Create 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.
<br/>
<b>If:</b>
<i>Applicability:</i>
Tetanus and diphtheria-containing vaccine booster dose 2 (delayed start)
<i>(Tetanus and diphtheria-containing vaccine booster dose 2 (delayed start))</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTCR.html">IMMZ.D2.DT.CR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('active')</i>
<br/>
payload.contentString: <i>(Tetanus and diphtheria-containing vaccine booster dose 2 (delayed start) Create)</i>
<br/>
category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>
<br/>
priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>
<br/>
</td>
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<tr>
<td>
<b> Pertussis-containing vaccine booster dose 1 (delayed start):</b> Provision of the pertussis-containing booster dose 1
Trigger event: The primary DTP series has been completed and client's age is between 1 year and 6 years
"Completed the primary vaccination series" = TRUE (where "Vaccine type" = "DTP-containing vaccines") AND 1 year ≤ Today's date − "Date of birth" ≤ 6 years
Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines")
Create 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).
<br/>
<b>If:</b>
<i>Applicability:</i>
Pertussis-containing vaccine booster dose 1 (delayed start)
<i>(Pertussis-containing vaccine booster dose 1 (delayed start))</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTCR.html">IMMZ.D2.DT.CR</a><br/>
<i>Dynamic Values:</i><br/>
status: <i>('active')</i>
<br/>
payload.contentString: <i>(Pertussis-containing vaccine booster dose 1 (delayed start) Create)</i>
<br/>
category.coding: <i>(Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' })</i>
<br/>
priority: <i>(Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' })</i>
<br/>
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Diphtheria–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"/>
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Trigger date: Date of birth
Create 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.
If tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong protection.
Pregnant women and their newborn infants are protected from birth-associated tetanus if the mother received 5 doses if first vaccinated during adolescence/adulthood."/>
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Trigger event: First DTP dose from the primary series was administered
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Trigger date: Latest "Date and time of vaccination" (where "Vaccine type" = "DTP-containing vaccines"
Create 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.
If tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong protection.
Pregnant women and their newborn infants are protected from birth-associated tetanus if the mother received 5 doses if first vaccinated during adolescence/adulthood."/>
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If tetanus vaccination is started during adolescence or adulthood, a total of only 5 appropriately spaced doses are required to obtain lifelong protection.
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Trigger event: The primary DTP series has been completed and client's age is between 1 year and 6 years
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<path value="status"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'active'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="payload.contentString"/>
<expression>
<language value="text/cql-identifier"/>
<expression
value="Pertussis-containing vaccine booster dose 1 (delayed start) Create"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="category.coding"/>
<expression>
<description value="Category of communication"/>
<language value="text/cql-expression"/>
<expression
value="Code { system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'alert' }"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="priority"/>
<expression>
<description value="Alert priority"/>
<language value="text/cql-expression"/>
<expression
value="Code { system: 'http://hl7.org/fhir/request-priority', code: 'routine' }"/>
</expression>
</dynamicValue>
</action>
</PlanDefinition>