Abstract
BACKGROUND: Vaccines are crucial for preventing infectious diseases; however, they may also be associated with adverse events (AEs). Conventional analysis of vaccine AEs relies on manual review and assignment of AEs to terms in terminology or ontology, which is a time-consuming process and constrained in scope. This study explores the potential of using Large Language Models (LLMs) and LLM text embeddings for efficient and comprehensive vaccine AE analysis. RESULTS: We used Llama-3 LLM to extract AE information from FDA-approved vaccine package inserts for 111 licensed vaccines, including 15 influenza vaccines. Text embeddings were then generated for each vaccine's AEs using the nomic-embed-text and mxbai-embed-large models. Llama-3 achieved over 80% accuracy in extracting AE text from vaccine package inserts. To further evaluate the performance of text embedding, the vaccines were clustered using two clustering methods: (1) LLM text embedding-based clustering and (2) ontology-based semantic similarity analysis. The ontology-based method mapped AEs to the Human Phenotype Ontology (HPO) and Ontology of Adverse Events (OAE), with semantic similarity analyzed using Lin's method. Text embeddings were generated for each vaccine's AE description using the LLM nomic-embed-text and mxbai-embed-large models. Compared to the semantic similarity analysis, the LLM approach was able to capture more differential AE profiles. Furthermore, LLM-derived text embeddings were used to develop a Lasso logistic regression model to predict whether a vaccine is "Live" or "Non-Live". The term "Non-Live" refers to all vaccines that do not contain live organisms, including inactivated and mRNA vaccines. A comparative analysis showed that, despite similar clustering patterns, the nomic-embed-text model outperformed the other. It achieved 80.00% sensitivity, 83.06% specificity, and 81.89% accuracy in a 10-fold cross-validation. Many AE patterns, with examples demonstrated, were identified from our analysis with AE LLM embeddings. CONCLUSION: This study demonstrates the effectiveness of LLMs for automated AE extraction and analysis, and LLM text embeddings capture latent information about AEs, enabling more comprehensive knowledge discovery. Our findings suggest that LLMs demonstrate substantial potential for improving vaccine safety and public health research.