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

: IMMZ.D2.DT.DTP.On-time start - XML Representation

Draft as of 2025-09-17

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<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="IMMZD2DTDTPOnTime"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"/>
    <profile
             value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareableplandefinition"/>
    <profile
             value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishableplandefinition"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
<div>
    <table class="grid dict">
        
        <tr>
            <th scope="row"><b>Id: </b></th>
            <td style="padding-left: 4px;">IMMZD2DTDTPOnTime</td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Url: </b></th>
            <td style="padding-left: 4px;"><a href="PlanDefinition-IMMZD2DTDTPOnTime.html">IMMZ.D2.DT.DTP.On-time start</a></td>
        </tr>
        

        
        <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.D2.DT.DTP.On-time start</td>
        </tr>
        

        

        
        <tr>
            <th scope="row"><b>Status: </b></th>
            <td style="padding-left: 4px;">draft</td>
        </tr>
        

        

        
        <tr>
            <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.D2.DT.DTP.On-time start
DTP vaccination schedule, on-time start (at ≤ 12 months of age)</p>
</div></td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Knowledge Capability: </b></th>
            <td style="padding-left: 4px;">
                
                computable 
            </td>
        </tr>
        

        

        

        

        

        

        

        

        

        

        
        <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>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Libraries: </b></th>
            <td style="padding-left: 4px;">
                <table class="grid-dict">
                    
                    <tr>
                        <td><a href="Library-IMMZD2DTDTPOnTimeLogic.html">IMMZD2DTDTPOnTimeLogic</a></td>
                    </tr>
                    
                </table>
            </td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Actions: </b></th>
            <td style="padding-left: 4px;">
                <table class="grid-dict">
                    
                    <tr>
                        <td>
                            
                            <b> Determine if the client is due for DTP.:</b> Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule, on-time start (at ≤ 12 months of age)
                            
                            <br/>
                            
                            
                            <b>If:</b>
                            
                            <i>Applicability:</i>
                            
                            Client is due for DTP vaccination
                            
                            <i>(Client is due for DTP vaccination)</i>
                            <br/>
                            
                            
                            
                            
                            <b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTDTPMR.html">IMMZ.D2.DT.DTP.MR</a><br/>
                            
                            <i>Dynamic Values:</i><br/>
                            
                            status: <i>('draft')</i>
                            <br/>
                            
                            intent: <i>('proposal')</i>
                            <br/>
                            
                            
                            
                            
                        </td>
                    </tr>
                    
                    <tr>
                        <td>
                            
                            <b> Determine if the client is due for DTP.:</b> Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule, on-time start (at ≤ 12 months of age)
                            
                            <br/>
                            
                            
                            <b>If:</b>
                            
                            <i>Applicability:</i>
                            
                            Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose
                            
                            <i>(Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose)</i>
                            <br/>
                            
                            
                            
                            
                            <b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTDTPTdMR.html">IMMZ.D2.DT.DTP.Td.MR</a><br/>
                            
                            <i>Dynamic Values:</i><br/>
                            
                            status: <i>('draft')</i>
                            <br/>
                            
                            intent: <i>('proposal')</i>
                            <br/>
                            
                            
                            
                            
                        </td>
                    </tr>
                    
                    <tr>
                        <td>
                            
                            <b> Determine if the client is due for DTP.:</b> Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule, on-time start (at ≤ 12 months of age)
                            
                            <br/>
                            
                            
                            <b>If:</b>
                            
                            <i>Applicability:</i>
                            
                            Client is due for tetanus and diphtheria booster dose
                            
                            <i>(Client is due for tetanus and diphtheria booster dose)</i>
                            <br/>
                            
                            
                            
                            
                            <b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTDTPTdMR.html">IMMZ.D2.DT.DTP.Td.MR</a><br/>
                            
                            <i>Dynamic Values:</i><br/>
                            
                            status: <i>('draft')</i>
                            <br/>
                            
                            intent: <i>('proposal')</i>
                            <br/>
                            
                            
                            
                            
                        </td>
                    </tr>
                    
                    <tr>
                        <td>
                            
                            <b> Determine if the client is due for DTP.:</b> Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule, on-time start (at ≤ 12 months of age)
                            
                            <br/>
                            
                            
                            <b>If:</b>
                            
                            <i>Applicability:</i>
                            
                            Primary DTP series is complete. Client is due for pertussis booster dose
                            
                            <i>(Primary DTP series is complete. Client is due for pertussis booster dose)</i>
                            <br/>
                            
                            
                            
                            
                            <b>Then:</b> <i>Definition:</i> <a href="ActivityDefinition-IMMZD2DTDTPPMR.html">IMMZ.D2.DT.DTP.Pertussis.MR</a><br/>
                            
                            <i>Dynamic Values:</i><br/>
                            
                            status: <i>('draft')</i>
                            <br/>
                            
                            intent: <i>('proposal')</i>
                            <br/>
                            
                            
                            
                            
                        </td>
                    </tr>
                    
                    <tr>
                        <td>
                            
                            <b> Check for Guidance for the patient regarding IMMZ.D2.DT.DTP.On-time start.:</b> Show Guidance for the patient regarding IMMZ.D2.DT.DTP.On-time start.
                            
                            <br/>
                            
                            
                            <b>If:</b>
                            
                            <i>Applicability:</i>
                            
                            Has Guidance
                            
                            <i>(Has Guidance)</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>(Guidance)</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>
                    </tr>
                    
                </table>
            </td>
        </tr>
        
    </table>
</div>
</div>
  </text>
  <extension
             url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
    <valueCode value="computable"/>
  </extension>
  <url
       value="http://smart.who.int/immunizations/PlanDefinition/IMMZD2DTDTPOnTime"/>
  <version value="0.2.0"/>
  <name value="IMMZD2DTDTPOnTime"/>
  <title value="IMMZ.D2.DT.DTP.On-time start"/>
  <type>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
      <code value="eca-rule"/>
    </coding>
  </type>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2025-09-17T23:03:28+00:00"/>
  <publisher value="WHO"/>
  <contact>
    <name value="WHO"/>
    <telecom>
      <system value="url"/>
      <value value="http://who.int"/>
    </telecom>
  </contact>
  <description
               value="IMMZ.D2.DT.DTP.On-time start
DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="WHO recommendations for routine immunization - summary tables (January 2025)"/>
  </relatedArtifact>
  <library
           value="http://smart.who.int/immunizations/Library/IMMZD2DTDTPOnTimeLogic"/>
  <action>
    <extension
               url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
      <valueMarkdown
                     value="A primary series of 3 doses of DTP-containing vaccine is recommended, with the first 
  dose administered as early as 6 weeks of age. Subsequent doses should be given with an interval of at least 4 weeks between doses."/>
    </extension>
    <title value="Determine if the client is due for DTP."/>
    <description
                 value="Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/>
    <condition>
      <kind value="applicability"/>
      <expression>
        <description value="Client is due for DTP vaccination"/>
        <language value="text/cql-identifier"/>
        <expression value="Client is due for DTP vaccination"/>
      </expression>
    </condition>
    <definitionCanonical
                         value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTDTPMR"/>
    <dynamicValue>
      <path value="status"/>
      <expression>
        <language value="text/cql-expression"/>
        <expression value="'draft'"/>
      </expression>
    </dynamicValue>
    <dynamicValue>
      <path value="intent"/>
      <expression>
        <language value="text/cql-expression"/>
        <expression value="'proposal'"/>
      </expression>
    </dynamicValue>
  </action>
  <action>
    <extension
               url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
      <valueMarkdown
                     value="Three booster doses of diphtheria toxoid-containing vaccine should be provided during childhood and adolescence. The 
  diphtheria booster doses should be given in combination with tetanus toxoid using the same schedule (i.e at 12–23 months of age, 
  4–7 years of age and 9–15 years of age, using age-appropriate vaccine formulations). Ideally, there should be at least 4 years 
  between booster doses. Member States may update this schedule based on their country context.  For children aged under 7 years, 
  diphtheria and tetanus toxoids and whole-cell pertussis (DTwP) vaccine or diphtheria and tetanus toxoids and acellular pertussis 
  (DTaP) combinations may be used. For children aged 4 years and older, tetanus toxoid, reduced diphtheria toxoid (Td)-containing 
  vaccine may be used and is preferred. From 7 years of age, only Td combinations should be used. Age-appropriate combinations-containing 
  pertussis vaccine with low-dose diphtheria antigen are also available. Only aP-containing vaccines should be used for vaccination of 
  persons aged 7 years and older.  National vaccination schedules can be adjusted within the age limits specified above to enable 
  programmes to tailor their schedules based on local epidemiology, the objectives of the immunization programme, any particular 
  programmatic issues and to better align tetanus vaccination with the immunological requirements of other vaccines (particularly 
  for pertussis and diphtheria)."/>
    </extension>
    <title value="Determine if the client is due for DTP."/>
    <description
                 value="Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/>
    <condition>
      <kind value="applicability"/>
      <expression>
        <description
                     value="Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose"/>
        <language value="text/cql-identifier"/>
        <expression
                    value="Primary DTP series is complete. Client is due for tetanus and diphtheria booster dose"/>
      </expression>
    </condition>
    <definitionCanonical
                         value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTDTPTdMR"/>
    <dynamicValue>
      <path value="status"/>
      <expression>
        <language value="text/cql-expression"/>
        <expression value="'draft'"/>
      </expression>
    </dynamicValue>
    <dynamicValue>
      <path value="intent"/>
      <expression>
        <language value="text/cql-expression"/>
        <expression value="'proposal'"/>
      </expression>
    </dynamicValue>
  </action>
  <action>
    <extension
               url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
      <valueMarkdown
                     value="Three booster doses of diphtheria toxoid-containing vaccine should be provided during childhood and adolescence. The 
  diphtheria booster doses should be given in combination with tetanus toxoid using the same schedule (i.e at 12–23 months of age, 
  4–7 years of age and 9–15 years of age, using age-appropriate vaccine formulations). Ideally, there should be at least 4 years 
  between booster doses. Member States may update this schedule based on their country context.  For children aged under 7 years, 
  diphtheria and tetanus toxoids and whole-cell pertussis (DTwP) vaccine or diphtheria and tetanus toxoids and acellular pertussis 
  (DTaP) combinations may be used. For children aged 4 years and older, tetanus toxoid, reduced diphtheria toxoid (Td)-containing 
  vaccine may be used and is preferred. From 7 years of age, only Td combinations should be used. Age-appropriate combinations-containing 
  pertussis vaccine with low-dose diphtheria antigen are also available. Only aP-containing vaccines should be used for vaccination of 
  persons aged 7 years and older.  National vaccination schedules can be adjusted within the age limits specified above to enable 
  programmes to tailor their schedules based on local epidemiology, the objectives of the immunization programme, any particular 
  programmatic issues and to better align tetanus vaccination with the immunological requirements of other vaccines (particularly 
  for pertussis and diphtheria)."/>
    </extension>
    <title value="Determine if the client is due for DTP."/>
    <description
                 value="Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/>
    <condition>
      <kind value="applicability"/>
      <expression>
        <description
                     value="Client is due for tetanus and diphtheria booster dose"/>
        <language value="text/cql-identifier"/>
        <expression
                    value="Client is due for tetanus and diphtheria booster dose"/>
      </expression>
    </condition>
    <definitionCanonical
                         value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTDTPTdMR"/>
    <dynamicValue>
      <path value="status"/>
      <expression>
        <language value="text/cql-expression"/>
        <expression value="'draft'"/>
      </expression>
    </dynamicValue>
    <dynamicValue>
      <path value="intent"/>
      <expression>
        <language value="text/cql-expression"/>
        <expression value="'proposal'"/>
      </expression>
    </dynamicValue>
  </action>
  <action>
    <extension
               url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale">
      <valueMarkdown
                     value="A pertussis booster dose is recommended for children aged 1–6 years, preferably during the second year of life (≥ 6 
  months after last primary dose), unless otherwise indicated by local epidemiology; the contact could also be used to catch up on 
  any missed doses of other vaccines. This schedule should provide protection for at least 6 years for countries using wP-containing 
  vaccine. For countries using aP-containing vaccine, protection may decline appreciably before 6 years of age.  Only aP-containing 
  vaccines should be used for vaccination of persons aged 7 years and over. Although a booster dose in adolescence has been shown to 
  decrease disease in adolescents, this is not generally recommended as a means of controlling pertussis in infants."/>
    </extension>
    <title value="Determine if the client is due for DTP."/>
    <description
                 value="Determine if the client is due for DTP vaccine according to the national immunization protocol.
DTP vaccination schedule, on-time start (at ≤ 12 months of age)"/>
    <condition>
      <kind value="applicability"/>
      <expression>
        <description
                     value="Primary DTP series is complete. Client is due for pertussis booster dose"/>
        <language value="text/cql-identifier"/>
        <expression
                    value="Primary DTP series is complete. Client is due for pertussis booster dose"/>
      </expression>
    </condition>
    <definitionCanonical
                         value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTDTPPMR"/>
    <dynamicValue>
      <path value="status"/>
      <expression>
        <language value="text/cql-expression"/>
        <expression value="'draft'"/>
      </expression>
    </dynamicValue>
    <dynamicValue>
      <path value="intent"/>
      <expression>
        <language value="text/cql-expression"/>
        <expression value="'proposal'"/>
      </expression>
    </dynamicValue>
  </action>
  <action>
    <title
           value="Check for Guidance for the patient regarding IMMZ.D2.DT.DTP.On-time start."/>
    <description
                 value="Show Guidance for the patient regarding IMMZ.D2.DT.DTP.On-time start."/>
    <condition>
      <kind value="applicability"/>
      <expression>
        <description value="Has Guidance"/>
        <language value="text/cql-identifier"/>
        <expression value="Has Guidance"/>
      </expression>
    </condition>
    <definitionCanonical
                         value="http://smart.who.int/immunizations/ActivityDefinition/IMMZD2DTCR"/>
    <dynamicValue>
      <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="Guidance"/>
      </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>