L1 extraction — smart-immunizations
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examples/l1-recommendation-scenarios/ (l1-recommendation-scenarios)
Not inside a library entry.
L1 statements (75)
75 recommendation
| id | type | statement | read from | file |
|---|---|---|---|---|
R01 | recommendation | Vaccination against measles is recommended for all susceptible children and adults. | §position, p. 220 | measles/measles-position-paper-2017.l1.yaml |
R02 | recommendation | The available live attenuated measles vaccines are safe and effective, provide long-lasting protection, are inexpensive and may be used interchangeably within immunization programmes. | §position, p. 220 | measles/measles-position-paper-2017.l1.yaml |
R03 | recommendation | Reaching all children with 2 doses of measles vaccine should be the standard for all national immunization programmes. | §position, p. 220 | measles/measles-position-paper-2017.l1.yaml |
R04 | recommendation | Countries aiming at measles elimination should achieve ≥95% coverage with both doses equitably to all children in every district. | §position, p. 220 | measles/measles-position-paper-2017.l1.yaml |
R05 | recommendation | In addition to the first routine dose of MCV (MCV1), all countries should include a second routine dose of MCV (MCV2) in their national vaccination schedules regardless of the level of MCV1 coverage. | §position, p. 220 | measles/measles-position-paper-2017.l1.yaml |
R06 | recommendation | As the addition of routine MCV2 covers only a single birth cohort and it takes time to achieve high rates of population-wide coverage, countries conducting regular campaigns to achieve high population immunity should consider cessation of campaigns only when >90–95% vaccination coverage has been achieved at the national level for both MCV1 and MCV2, as determined by accurate coverage data for a p… | §position, p. 221 | measles/measles-position-paper-2017.l1.yaml |
R07 | recommendation | In countries with ongoing transmission in which the risk of measles mortality among infants remains high, MCV1 should be administered at 9 months of age. | §timing, p. 221 | measles/measles-position-paper-2017.l1.yaml |
R08 | recommendation | These countries should administer the routine dose of MCV2 at age 15–18 months. | §timing, p. 221 | measles/measles-position-paper-2017.l1.yaml |
R09 | recommendation | The minimum interval between MCV1 and MCV2 is 4 weeks. | §timing, p. 221 | measles/measles-position-paper-2017.l1.yaml |
R10 | recommendation | In countries with low levels of measles transmission (i.e. those nearing measles elimination or verified as having eliminated endemic measles virus transmission) and therefore the risk of measles virus infection among infants is low, MCV1 may be administered at 12 months of age to take advantage of the higher seroconversion rates achieved at this age. | §timing, p. 221 | measles/measles-position-paper-2017.l1.yaml |
R11 | recommendation | In countries where MCV1 is administered at 12 months of age, the optimal age for delivering routine MCV2 is based on programmatic considerations that achieve the highest coverage of MCV2 and, hence, the highest population immunity. | §timing, p. 221 | measles/measles-position-paper-2017.l1.yaml |
R12 | recommendation | If MCV1 coverage is high (>90%) and school enrolment is high (>95%), administration of routine MCV2 at school entry may prove an effective strategy for achieving high coverage and preventing outbreaks in schools. | §timing, p. 221 | measles/measles-position-paper-2017.l1.yaml |
R13 | recommendation | In the following situations, a supplementary dose of MCV should be given to infants from 6 months of age: | §timing, p. 221 | measles/measles-position-paper-2017.l1.yaml |
R13.1 | recommendation | during a measles outbreak as part of intensified service delivery; | §timing, p. 221 | measles/measles-position-paper-2017.l1.yaml |
R13.2 | recommendation | during campaigns in settings where the risk of measles among infants < 9 months of age remains high (e.g. in endemic countries experiencing regular outbreaks); | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R13.3 | recommendation | for internally displaced populations and refugees, and populations in conflict zones; | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R13.4 | recommendation | for individual infants at high risk of contracting measles (e.g. contacts of known measles cases or in settings with increased risk of exposure during outbreaks such as day-care facilities); | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R13.5 | recommendation | for infants travelling to countries experiencing measles outbreaks; | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R13.6 | recommendation | for infants known to be HIV-infected or exposed (i.e. born to an HIV-infected woman). | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R14 | recommendation | MCV administered before 9 months of age should therefore be considered a supplementary dose and recorded on the child’s vaccination record as “MCV0” unless the country has data showing high seroconversion when vaccination is carried out before 9 months of age. | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R15 | recommendation | Children who receive a MCV0 dose should also receive MCV1 and MCV2 at the recommended ages according to the national schedule. | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R16 | recommendation | Countries using MR or MMR in their national schedule should use the combined vaccine rather than measles-only formulations in all children, including those aged <1 year. | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R17 | recommendation | Because many cases of measles occur in children aged >12 months who have not been vaccinated, routine delivery of MCV1 should not be limited to infants aged 9–12 months and routine delivery of MCV2 should not be limited to infants aged 15–18 months of age. | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R18 | recommendation | Every opportunity (e.g. whenever children come in contact with health services) should be taken to vaccinate all children who missed one or both MCV routine doses, particularly those <15 years of age. | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R19 | recommendation | Policies prohibiting the use of the vaccine in children >1 year of age, older children and adolescents should be changed to allow them to be vaccinated as necessary. | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R20 | recommendation | Irrespective of the strategy or schedule, the child’s immunization card and the clinic’s vaccination register should be designed to allow accurate recording of supplementary (MCV0), routine (MCV1 and MCV2) and campaign doses. | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R21 | recommendation | Children should be screened for their measles vaccination history at the time of school entry, and those lacking evidence of receipt of 2 doses should be vaccinated with any missing doses. | §timing, p. 222 | measles/measles-position-paper-2017.l1.yaml |
R22 | recommendation | In countries where health systems are functioning only moderately or weakly, implementation of regular measles vaccination campaigns can be a highly effective strategy for protecting children who do not have access to routine health services, particularly if hard-to-reach communities are targeted during the campaign. | §campaigns, p. 222–223 | measles/measles-position-paper-2017.l1.yaml |
R23 | recommendation | Because the risk of measles outbreaks is determined by the rate of accumulation of susceptible people in the population, programmes should use available good quality data on population immunity (i.e. vaccination coverage, surveillance, serological studies) to monitor the accumulation of susceptible people and conduct follow-up campaigns before the number of pre-school children susceptible to meas… | §campaigns, p. 223 | measles/measles-position-paper-2017.l1.yaml |
R24 | recommendation | As there is no single criterion for identification of the target age range for measles or measles/rubella vaccination campaigns, countries should integrate their surveillance, demographic, survey and seroprevalence data together with vaccination coverage information, history of MCV and RCV use, and local knowledge to determine the age distribution of susceptibility (age-specific immunity gaps) an… | §campaigns, p. 223 | measles/measles-position-paper-2017.l1.yaml |
R25 | recommendation | All MCV campaigns should follow established best practices, should be monitored to ensure readiness before the campaign, and be independently monitored during and after the campaign to ensure homogeneous vaccination coverage of >95%. | §campaigns, p. 224 | measles/measles-position-paper-2017.l1.yaml |
R26 | recommendation | All doses given during campaigns should be documented in the child’s vaccination record and the number of zero-dose children vaccinated (i.e. children who had not received any previous doses of MCV) recorded by age group. | §campaigns, p. 224 | measles/measles-position-paper-2017.l1.yaml |
R27 | recommendation | Before discontinuing campaigns, a review should be conducted by a national committee such as the national immunization advisory group. | §campaigns, p. 224 | measles/measles-position-paper-2017.l1.yaml |
R28 | recommendation | In the absence of adequate data, or if data suggest that cessation of campaigns would allow population immunity to drop below the herd immunity threshold, campaigns should continue. | §campaigns, p. 224 | measles/measles-position-paper-2017.l1.yaml |
R29 | recommendation | All commercially available live attenuated measles vaccines, either as monovalent vaccine or in combination with rubella, mumps, or varicella vaccines, or some combination of these, can be used interchangeably to protect against measles. | §choice, p. 224 | measles/measles-position-paper-2017.l1.yaml |
R30 | recommendation | However, for programmatic reasons (e.g. to reduce cold storage needs and vaccine wastage), it is recommended that the same formulation is used for both routine doses of MCV. | §choice, p. 224 | measles/measles-position-paper-2017.l1.yaml |
R31 | recommendation | As a general rule, live vaccines should be given either simultaneously or at intervals of 4 weeks. | §coadmin, p. 224 | measles/measles-position-paper-2017.l1.yaml |
R32 | recommendation | MCVs may be co-administered at different anatomical sites with other vaccines including Japanese encephalitis vaccine, yellow fever vaccine, DTP-containing vaccines, meningococcal vaccine, hepatitis B vaccine, inactivated poliovirus vaccine, Haemophilus influenza type b conjugate vaccine, and pneumococcal vaccines. | §coadmin, p. 224 | measles/measles-position-paper-2017.l1.yaml |
R33 | recommendation | MCVs should not be given to individuals with a history of anaphylactic reactions or severe allergic reactions to any component of the vaccine (e.g. neomycin or gelatin) or those with any form of severe immunosuppression. | §contra, p. 225 | measles/measles-position-paper-2017.l1.yaml |
R34 | recommendation | As a precautionary measure, measles vaccine – alone or in combination with other vaccines – should be avoided during pregnancy. | §pregnancy, p. 225 | measles/measles-position-paper-2017.l1.yaml |
R35 | recommendation | Because of the known risk of spreading measles from HCWs to patients or from patients to HCWs, all HCWs and any staff who are in contact with patients should be immune to measles. | §hcw, p. 225 | measles/measles-position-paper-2017.l1.yaml |
R36 | recommendation | Verification of vaccination and/or history of measles should be integrated into standard infection control guidelines or other standards of care for health-care workers. | §hcw, p. 225 | measles/measles-position-paper-2017.l1.yaml |
R37 | recommendation | For HCWs who have contact with patients, documentation of immunity should be required before signing an employment contract or entering into a training programme. | §hcw, p. 225 | measles/measles-position-paper-2017.l1.yaml |
R38 | recommendation | Vaccine should be offered to children from 6 months of age, adolescents and adults likely or known to be susceptible. | §travel, p. 225 | measles/measles-position-paper-2017.l1.yaml |
R39 | recommendation | Given the severe course of measles in patients with AIDS, measles vaccination should be routinely administered to potentially susceptible, asymptomatic HIV-infected children and adults. | §hiv, p. 225 | measles/measles-position-paper-2017.l1.yaml |
R40 | recommendation | Vaccination may even be considered for those with symptomatic HIV infection if they are not severely immunosuppressed according to conventional definitions. | §hiv, p. 225 | measles/measles-position-paper-2017.l1.yaml |
R41 | recommendation | In areas where there is a high incidence of both HIV infection and measles, an initial dose of MCV may be offered as early as age 6 months (recorded as MCV0). The 2 routine doses of MCV (MCV1 and MCV2) should then be administered to these children according to the national immunization schedule. | §hiv, p. 225 | measles/measles-position-paper-2017.l1.yaml |
R42 | recommendation | An additional dose of MCV should be administered to HIV-infected children receiving HAART following immune reconstitution. | §hiv, p. 226 | measles/measles-position-paper-2017.l1.yaml |
R43 | recommendation | If CD4+ T lymphocyte counts are monitored, an additional dose of MCV should be administered when immune reconstitution has been achieved, e.g. when the CD4+ T lymphocyte count reaches 20–25%. | §hiv, p. 226 | measles/measles-position-paper-2017.l1.yaml |
R44 | recommendation | Where CD4+ T lymphocyte monitoring is not available, children should receive an additional dose of MCV 6–12 months after initiation of HAART. | §hiv, p. 226 | measles/measles-position-paper-2017.l1.yaml |
R45 | recommendation | A supplementary dose of MCV (recorded as MCV0) should be considered for infants known to be exposed (i.e. born to an HIV-infected woman) or soon after diagnosis of HIV infection in children older than 6 months who are not receiving HAART and for whom the risk of measles is high, with the aim of providing partial protection until they are revaccinated after immune reconstitution with HAART. | §hiv, p. 226 | measles/measles-position-paper-2017.l1.yaml |
R46 | recommendation | As countries approach elimination, they should intensify surveillance and move towards weekly reporting to the WHO regional offices. | §surveillance, p. 226 | measles/measles-position-paper-2017.l1.yaml |
R47 | recommendation | To limit the impact of measles outbreaks, WHO recommends surveillance for early detection, thorough assessment of the risk of spread and of severe disease outcomes, identification of immunity gaps, and planning rapid responses, including expanded use of MCVs. | §surveillance, p. 226 | measles/measles-position-paper-2017.l1.yaml |
R48 | recommendation | A district or regional outbreak coordination committee with broad representation should make the decisions about the type of vaccination response to be implemented at the local level. | §surveillance, p. 226 | measles/measles-position-paper-2017.l1.yaml |
R49 | recommendation | To protect individuals at high risk during an outbreak, vaccination within 72 hours of exposure may be given to modify the clinical course of measles or prevent symptoms. | §surveillance, p. 226 | measles/measles-position-paper-2017.l1.yaml |
R50 | recommendation | In individuals for whom vaccination is contraindicated, the administration of measles immune globulin within 6 days of exposure may have a similarly beneficial effect. | §surveillance, p. 226 | measles/measles-position-paper-2017.l1.yaml |
R51 | recommendation | When determining whether a country or the WHO Region as a whole has achieved elimination, the regional verification commission should consider 5 lines of evidence – disease epidemiology, population immunity, quality of surveillance, sustainability of the programme, and genotyping evidence – to allow for a comprehensive evidence-based assessment of past programme performance and future capacity to… | §surveillance, p. 227 | measles/measles-position-paper-2017.l1.yaml |
R52 | recommendation | Research targeting programmatic challenges is likely to yield the most programmatic gains and should be prioritized. | §research, p. 227 | measles/measles-position-paper-2017.l1.yaml |
V01 | recommendation | In general, it is recommended that freeze-dried vaccine be stored in a refrigerated condition below +8 °C. | §vaccine-chars, p. 213 | measles/measles-position-paper-2017.l1.yaml |
V02 | recommendation | The diluent must not be frozen and can be stored at ambient temperature; it should be cooled to 2–8 °C before reconstitution. | §vaccine-chars, p. 213 | measles/measles-position-paper-2017.l1.yaml |
V03 | recommendation | The vaccine is also sensitive to light and should be stored in coloured glass vials protected from sunlight. | §vaccine-chars, p. 213 | measles/measles-position-paper-2017.l1.yaml |
V04 | recommendation | After reconstitution, the vaccine must be stored in the dark at 2–8 °C and used within 6 hours. | §vaccine-chars, p. 213 | measles/measles-position-paper-2017.l1.yaml |
V05 | recommendation | Mild, concurrent infections are not considered a contraindication to vaccination, but MCVs should be avoided if the patient has a high fever or other signs of serious acute illness. | §safety, p. 217 | measles/measles-position-paper-2017.l1.yaml |
C01 | recommendation | Since measles is highly contagious, patient isolation is an important intervention to prevent further spread of the virus. | §treatment, p. 210 | measles/measles-position-paper-2017.l1.yaml |
C02 | recommendation | Supportive care should be provided, including relieving common symptoms such as fever, cough, nasal congestion or rhinorrhea, conjunctivitis, and sore mouth. | §treatment, p. 210 | measles/measles-position-paper-2017.l1.yaml |
C03 | recommendation | Nutritional support is recommended to reduce the risk of malnutrition due to diarrhoea, vomiting and poor appetite associated with measles. | §treatment, p. 210 | measles/measles-position-paper-2017.l1.yaml |
C04 | recommendation | Breastfeeding should be encouraged where appropriate. | §treatment, p. 210 | measles/measles-position-paper-2017.l1.yaml |
C05 | recommendation | Oral rehydration salts should be used as needed to prevent dehydration. | §treatment, p. 210 | measles/measles-position-paper-2017.l1.yaml |
C06 | recommendation | Although one study reported that patients who received prophylactic antibiotics had fewer episodes of pneumonia and conjunctivitis and greater weight gain, antibiotics are generally not recommended for the treatment of measles unless secondary bacterial complications develop, such as pneumonia or otitis media. | §treatment, p. 210 | measles/measles-position-paper-2017.l1.yaml |
C07 | recommendation | Vitamin A should be administered to all acute cases irrespective of the timing of previous doses of vitamin A. | §treatment, p. 210 | measles/measles-position-paper-2017.l1.yaml |
C08 | recommendation | Vitamin A oral dosage should be given immediately on diagnosis and repeated the next day; 50 000 IU should be given to infants aged <6 months, 100 000 IU to infants aged 6–11 months and 200 000 IU to children aged ≥12 months. | §treatment, p. 210 | measles/measles-position-paper-2017.l1.yaml |
C09 | recommendation | If the child has clinical ophthalmic signs of vitamin A deficiency such as Bitot’s spots, a third dose should be given 4–6 weeks later. | §treatment, p. 210 | measles/measles-position-paper-2017.l1.yaml |
C10 | recommendation | Even in countries where measles is not usually severe, vitamin A should be given in all cases of severe measles. | §treatment, p. 210–211 | measles/measles-position-paper-2017.l1.yaml |
C11 | recommendation | In unimmunized or insufficiently immunized individuals, measles vaccine may be administered within 72 hours of exposure to measles virus to protect against disease. | §pep, p. 211 | measles/measles-position-paper-2017.l1.yaml |
C12 | recommendation | For susceptible individuals for whom MCV is contraindicated, human immune globulin may be given after measles virus exposure, particularly to pregnant women, infants aged <6 months, and individuals with impaired immune systems. | §pep, p. 211 | measles/measles-position-paper-2017.l1.yaml |
Graph documents (1)
measles/candidates/scenario-candidates.l2.json
Context http://smart.who.int/kg/l2.context.jsonld; graph https://smart.who.int/immunizations/graph/l1-scenarios/immz-measles-wer9217.
| node type | nodes |
|---|---|
user-scenario | 75 |
persona | 10 |
business-process | 4 |
| edge predicate | edges |
|---|---|
involves | 78 |
implementedBy | 75 |
realises | 42 |
Files (6)
| file | what it is | holds | bytes | open |
|---|---|---|---|---|
README.md | Markdown | 1,657 | source | |
measles/candidates/scenario-candidates.l2.json | JSON-LD graph | 89 node(s), 195 edge(s) | 282,355 | source |
measles/candidates/scenario-warnings.md | Markdown | 9,687 | source | |
measles/immz-vocabulary.json | l1-scenario-vocabulary/v1 | 8 persona(s), 9 process(es) | 8,808 | source |
measles/measles-immz-mapping.yaml | l1-scenario-mapping/v1 | 75 mapped statement(s) | 48,559 | source |
measles/measles-position-paper-2017.l1.yaml | authored L1 source | 75 recommendation(s) of Measles vaccines: WHO position paper – April 2017 | 49,640 | source |
Every instance
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- smart-immunizations