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However, little attention has been given to the lived experiences of caregivers and how they made decisions about participating in the vaccine pilot implementation. This paper takes an interpretive phenomenological analysis lens to understand caregivers\u2019 process of negotiating participation in the pilot implementation. I conducted 11 in-depth interviews with caregivers in the RTS,S pilot implementation site in the Assin North district in Ghana. Findings reveal that participants engaged in three overarching sense-making processes to negotiate their involvement in the pilot. These were\n                    <jats:italic toggle=\"yes\">questioning the vaccine<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">considering political and socio-economic concerns<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">biting the bullet.<\/jats:italic>\n                    Embodied within these themes are how agency, power, politics, trust in healthcare workers, and knowledge of vaccines undergird respondents\u2019 decision-making regarding the pilot implementation. The study evidenced the need for a holistic approach to engaging community members in pilot sites to guide their vaccine decision-making. By identifying the complex decision-making processes that individuals go through, we can better inform vaccine policy and public messaging to guide vaccine decision-making.\n                  <\/jats:p>","DOI":"10.1177\/10497323251347922","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T12:04:59Z","timestamp":1749816299000},"page":"1284-1297","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Sense-Making During the RTS,S Malaria Vaccine Pilot Implementation in Ghana"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0772-0997","authenticated-orcid":false,"given":"Esi Thompson","family":"Tani-Eshon","sequence":"first","affiliation":[{"name":"Indiana University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"e_1_3_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41256-022-00255-1"},{"key":"e_1_3_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13753-024-00598-y"},{"key":"e_1_3_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czac077"},{"key":"e_1_3_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15481-6"},{"key":"e_1_3_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvacx.2023.100283"},{"key":"e_1_3_7_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-12432-x"},{"key":"e_1_3_7_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0166951"},{"issue":"2","key":"e_1_3_7_9_1","first-page":"6","article-title":"Gender, vulnerability and the politics of decision-making in Ghana: The case of the Upper East Region","volume":"1","author":"Apusigah A. 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