Merge pull request #3785 from nhsuk/vaccine-side-effects

Add side effects to vaccines

Author: murugapl

app/lib/govuk_notify_personalisation.rb

@@ -65,7 +65,8 @@ def to_h
       team_name:,
       team_phone:,
       today_or_date_of_vaccination:,
-      vaccination:
+      vaccination:,
+      vaccine_side_effects:
     }.compact
   end
 
@@ -286,4 +287,20 @@ def vaccination
       programmes.count == 1 ? "vaccination" : "vaccinations"
     ].join(" ")
   end
+
+  def vaccine_side_effects
+    side_effects =
+      if vaccination_record
+        vaccination_record.vaccine&.side_effects
+      elsif programmes.present?
+        Vaccine.where(programme: programmes).flat_map(&:side_effects)
+      end
+
+    return if side_effects.nil?
+
+    descriptions =
+      side_effects.map { Vaccine.human_enum_name(:side_effect, it) }.sort.uniq
+
+    descriptions.map { "- #{it}" }.join("\n")
+  end
 end

app/models/concerns/has_side_effects.rb

@@ -0,0 +1,29 @@
+# frozen_string_literal: true
+
+module HasSideEffects
+  extend ActiveSupport::Concern
+
+  included do
+    extend ArrayEnum
+
+    array_enum side_effects: {
+                 aching: 0,
+                 dizziness: 1,
+                 drowsy: 2,
+                 feeling_sick: 3,
+                 headache: 4,
+                 high_temperature: 5,
+                 irritable: 6,
+                 loss_of_appetite: 8,
+                 pain_in_arms: 9,
+                 raised_temperature: 10,
+                 rash: 11,
+                 runny_blocked_nose: 12,
+                 swelling: 13,
+                 tiredness: 14,
+                 unwell: 15
+               }
+
+    validates :side_effects, subset: side_effects.keys
+  end
+end

app/models/concerns/has_vaccine_methods.rb

@@ -8,7 +8,7 @@ module HasVaccineMethods
 
     array_enum vaccine_methods: { injection: 0, nasal: 1 }
 
-    validates :vaccine_methods, subset: %w[injection nasal]
+    validates :vaccine_methods, subset: vaccine_methods.keys
   end
 
   def vaccine_method_injection? = vaccine_methods.include?("injection")

app/models/vaccine.rb

@@ -11,6 +11,7 @@
 #  manufacturer        :text             not null
 #  method              :integer          not null
 #  nivs_name           :text             not null
+#  side_effects        :integer          default([]), not null, is an Array
 #  snomed_product_code :string           not null
 #  snomed_product_term :string           not null
 #  created_at          :datetime         not null
@@ -30,6 +31,8 @@
 #  fk_rails_...  (programme_id => programmes.id)
 #
 class Vaccine < ApplicationRecord
+  include HasSideEffects
+
   audited associated_with: :programme
   has_associated_audits
 

config/locales/en.yml

@@ -231,6 +231,22 @@ en:
           injection: Injection
           nasal: Nasal spray
           nasal_injection: Nasal spray (or injection)
+        side_effects:
+          aching: an aching body
+          dizziness: dizziness
+          drowsy: feeling drowsy
+          feeling_sick: feeling sick
+          headache: a headache
+          high_temperature: a high temperature
+          irritable: feeling irritable
+          loss_of_appetite: loss of appetite
+          pain_in_arms: pain in the arms, hands, fingers
+          raised_temperature: a slightly raised temperature
+          rash: a rash
+          runny_blocked_nose: a runny or blocked nose
+          swelling: swelling or pain where the injection was given
+          tiredness: general tiredness
+          unwell: generally feeling unwell
     errors:
       models:
         class_import:

db/migrate/20250619125105_add_side_effects_to_vaccines.rb

@@ -0,0 +1,12 @@
+# frozen_string_literal: true
+
+class AddSideEffectsToVaccines < ActiveRecord::Migration[8.0]
+  def change
+    add_column :vaccines,
+               :side_effects,
+               :integer,
+               array: true,
+               default: [],
+               null: false
+  end
+end

db/schema.rb

@@ -842,6 +842,7 @@
     t.text "nivs_name", null: false
     t.boolean "discontinued", default: false, null: false
     t.bigint "programme_id", null: false
+    t.integer "side_effects", default: [], null: false, array: true
     t.index ["manufacturer", "brand"], name: "index_vaccines_on_manufacturer_and_brand", unique: true
     t.index ["nivs_name"], name: "index_vaccines_on_nivs_name", unique: true
     t.index ["programme_id"], name: "index_vaccines_on_programme_id"

lib/tasks/vaccines.rake

@@ -26,6 +26,8 @@ namespace :vaccines do
       vaccine.snomed_product_term = data["snomed_product_term"]
       vaccine.programme = programme
 
+      vaccine.side_effects = side_effects_for(programme, data["method"])
+
       vaccine.save!
 
       next if vaccine.health_questions.exists?
@@ -47,6 +49,61 @@ namespace :vaccines do
   end
 end
 
+def side_effects_for(programme, method)
+  if programme.flu?
+    if method == "nasal"
+      %w[runny_blocked_nose headache tiredness loss_of_appetite]
+    else
+      %w[
+        swelling
+        headache
+        high_temperature
+        feeling_sick
+        irritable
+        drowsy
+        loss_of_appetite
+        unwell
+      ]
+    end
+  elsif programme.hpv?
+    %w[
+      swelling
+      headache
+      high_temperature
+      feeling_sick
+      irritable
+      drowsy
+      loss_of_appetite
+      unwell
+    ]
+  elsif programme.menacwy?
+    %w[
+      drowsy
+      feeling_sick
+      headache
+      high_temperature
+      irritable
+      loss_of_appetite
+      rash
+      swelling
+      unwell
+    ]
+  elsif programme.td_ipv?
+    %w[
+      drowsy
+      feeling_sick
+      headache
+      high_temperature
+      irritable
+      loss_of_appetite
+      swelling
+      unwell
+    ]
+  else
+    raise UnsupportedProgramme, programme
+  end
+end
+
 def create_flu_health_questions(vaccine)
   asthma =
     if vaccine.nasal?

spec/factories/vaccines.rb

@@ -11,6 +11,7 @@
 #  manufacturer        :text             not null
 #  method              :integer          not null
 #  nivs_name           :text             not null
+#  side_effects        :integer          default([]), not null, is an Array
 #  snomed_product_code :string           not null
 #  snomed_product_term :string           not null
 #  created_at          :datetime         not null

spec/lib/govuk_notify_personalisation_spec.rb

@@ -73,7 +73,8 @@
         team_email: "organisation@example.com",
         team_name: "Organisation",
         team_phone: "01234 567890 (option 1)",
-        vaccination: "HPV vaccination"
+        vaccination: "HPV vaccination",
+        vaccine_side_effects: ""
       }
     )
   end
@@ -241,4 +242,19 @@
       )
     end
   end
+
+  context "with vaccine side effects" do
+    before do
+      programmes.first.vaccines.first.update!(side_effects: %w[swelling unwell])
+    end
+
+    it do
+      expect(to_h).to match(
+        hash_including(
+          vaccine_side_effects:
+            "- generally feeling unwell\n- swelling or pain where the injection was given"
+        )
+      )
+    end
+  end
 end