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Vaccine Hesitancy

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What & Why?

With the COVID-19 pandemic sweeping the globe, the development of an effective vaccine has been crucial to stopping the spread and danger of the virus. However, many people share differing views over vaccination and certain social groups in particular may be more or less likely to want or receive the vaccine, but what are these groups and why are they more hesitant? 

Ethnicity?

Razai, Osama, McKechnie, & Majeed (2021) present that COVID-19 vaccine hesitancy among ethnic groups varies quite significantly. The importance of understanding these disparities only increases as mass vaccination efforts are being made, especially in nations such as the UK where there are many different social groups and large-scale COVID-19 outbreaks. Statistics up to the 14th of February 2021 showed that over 90% of adults in Britain have received or would be likely to accept the COVID-19 vaccine if they were offered it. On the other hand, some surveys have indicated much greater vaccine hesitancy among people from certain ethnic minorities. A UK based survey in December 2020 reported that vaccine hesitancy was highest among Black, Bangladeshi, and Pakistani populations when compared alongside people from a White ethnic background. Data from the NHS trust shows lower COVID-19 vaccination rates among ethnicities who are even healthcare workers (70.9% in White workers, 58.5% in South Asian, & 36.8% in Black workers).

It is so important to understand and mitigate these differences as the pandemic continues to have a disproportionate effect on people from ethnic minorities, with higher COVID-19 morbidity and mortality rates for the ethnic minorities showing higher vaccine hesitancy, and greater adverse socioeconomic consequences.

Vaccine hesitancy, characterised by uncertainty and ambivalence about vaccination, is a legitimate viewpoint, underscoring the failure or lack of effective public health messaging. Those who are hesitant can still be convinced of the vaccines’ safety, efficacy, and necessity. It is also important to state that being vaccine hesitant is very different from being an “anti-vaxxer”. The most common reasons for vaccine hesitancy for COVID-19 are genuine concerns about long-term side effects for health which is a fair argument to make (particularly found in young and Black respondents). 

Willis et al. (2021) surveyed Arkansas adults in 2020 and found 1 in 5 people reported hesitancy to take a COVID-19 vaccine. Prevalence of COVID-19 vaccine hesitancy was highest for Black/African Americans. The odds of COVID-19 vaccine hesitancy were more than twice as high for Black/African American respondents when compared to White respondents.

Socio-economic?

Willis et al. (2021) also found that respondents in their study with annual household incomes of less than $25K and lesser levels of education were the next highest groups after Black/African Americans to have the highest vaccine hesitancy.

Bertoncello et al. (2020) furthermore support this trend of lower socio-economic backgrounds showing higher vaccine hesitancy. It was reported that rising levels of perceived economic hardship were associated with greater vaccine hesitancy, meanwhile, lower parental education was significantly associated with outright refusal of vaccinations.

Guary et al. (2019) conducted a total of 8,737 interviews across Quebec, Canada. Among all respondents, 32.2% were vaccine hesitant. It was highlighted that several beliefs were significantly associated with vaccine hesitancy. These were; the belief that children receive too many vaccines, the belief that a healthy lifestyle can eliminate the need for vaccination, and the belief that the use of alternative medicine practices can eliminate the need for vaccination. There were also other determinants associated with vaccine hesitancy such as having a low (less than $30,000) or even moderate ($30,000–$79,000) household income, distrust in public health authorities, perceived insufficient knowledge about immunisation, and smoking. These findings suggest that those on the lower socio-economic end of the scale have higher vaccine hesitancy, as well as sharing other determinants that could lead to this. Engagement in well known unhealthy activities such as smoking may explain higher vaccine hesitancy in regards to ignoring or dismissing negative health impacts. It can also be seen that distrust and perceived lack of proper education about vaccines are also strong reasons for people being hesitant. This emphasises the need for widespread and clear education about realistic impacts and scientific support for vaccines to bolster these groups of people to engage with them.

To see more about vaccine hesitancy please see the links below:

Bertoncello, C., Ferro, A., Fonzo, M., Zanovello, S., Napoletano, G., Russo, F., … & Cocchio, S. (2020). Socioeconomic determinants in vaccine hesitancy and vaccine refusal in Italy. Vaccines, 8(2), 276.

Guay, M., Gosselin, V., Petit, G., Baron, G., & Gagneur, A. (2019). Determinants of vaccine hesitancy in Quebec: a large population-based survey. Human vaccines & immunotherapeutics.

Razai, M. S., Osama, T., McKechnie, D. G., & Majeed, A. (2021). Covid-19 vaccine hesitancy among ethnic minority groups.

Willis, D. E., Andersen, J. A., Bryant‐Moore, K., Selig, J. P., Long, C. R., Felix, H. C., … & McElfish, P. A. (2021). COVID‐19 vaccine hesitancy: Race/ethnicity, trust, and fear. Clinical and Translational Science.

Thank You,

Jack Pink

Fundraising & Marketing Intern

We are hiring!

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Are you an organised, quick-thinking individual who is passionate about bringing equity to the medical admissions process and who wants to help transform lives today and far into the future?

If that sounds like you and you are ready for a small role with big potential, working for a small charity with big potential then keep reading!

Who we are: At the Armitage Foundation we believe that every person with the desire and aptitude to study medicine should be able to do so, regardless of their background. As such, we aim to inspire, empower, and equip young people from underrepresented backgrounds to study medicine.

What we do: We work with schools and universities to give young people from underrepresented backgrounds the same opportunities, insight and support that is routinely received by their more privileged counterparts. We do this by managing the delivery of three, two-year medical access programmes which are co-designed and delivered by medical students to young people from low socioeconomic backgrounds and underrepresented ethnic minorities. These programmes are designed to help young people from low socioeconomic and minority ethnicity backgrounds to make informed decisions from pre-GCSE through to the university application process by developing:
• Understanding of the industry – what it means to be a doctor and the pathways and requirements needed to study medicine
• Skills and experience – improved soft skills such as communication; cultural experiences such as university visits and other opportunities traditionally only available to more privileged students; work experience
• Growth mindset – improved belief in abilities, and that opportunities can be improved with hard work
• Self-belief – the confidence to growth strengths and the ability to overcome challenges
• Aspirations – setting specific goals and applying flexibility and motivation to achieve them.
• Social capital – knowing who to ask for support and advice

Our team: Led by our co-founders, Leanne Armitage and Daniel Huf, our team consists of seven trustees and one permanent, part time member of staff. We also have 12 committed and talented Armitage Ambassadors and one fantastic social media and marketing intern. Although small, our team is ambitious, and every member works hard to achieve the charity’s aims.


About the Armitage Programmes: Our programmes each consist of 12-14 sessions which are delivered over the space of two years in schools (or, due to the pandemic, electronically) to ten students (per school) who meet our criteria. Armitage Juniors for academic years 8-9, Seniors for years 10-11 and Scholars for years 12-13 have been designed to offer a valuable insight into the many career opportunities available to people who pursue a career in medicine.
Current activities: We currently work with two universities, piloting Armitage Juniors in five schools in London. With ambitious growth plans, we expect to more than double our reach over the next year, as well as piloting Armitage Seniors.

Job purpose: To support the delivery of the Armitage Programmes. This position requires an individual who is meticulously organised, self-motivated and an excellent communicator who works well as a critical part of a small team.

Key responsibilities:
• Support the delivery of the programmes including scheduling dates with schools, universities and Ambassadors
• Arranging delivery of necessary equipment or resources to schools
• Ensuring Ambassadors have everything they need to deliver sessions
• Manage all associate programme communications – which can often mean reaching out to teachers in a busy school environment
• Submitting monthly timesheets to partner universities
• Maintain relationship with existing and new stakeholders
• Support the development of digital programme delivery
• Seeking local fundraising opportunities, where appropriate
• Other occasional administrative and marketing tasks commensurate with the role

As this is a new role in a small charity, there is scope for the role to develop considerably in the future. As such, it would suit someone who only has limited time to commit now, but who may be looking to develop opportunities and potentially increase their hours as the charity grows.

Person specification:
Essential:
• A positive, proactive outlook
• Outstanding communication skills
• Excellent relationship management skills
• High levels of attention to detail and organisation skills
• High computer literacy– adept at Microsoft Word, Excel and PowerPoint
• Ability to prioritise tasks and use own initiative is
• Previous programme coordination/ administration roles
• Excellent written and oral skills
• A willingness to learn
• Excellent time management
• A clear understanding of our cause and motivations and a passion to drive change by helping us to deliver our vision.

Advantageous
• Ability to use – or quickly pick up – other digital platforms and applications is an advantage
• Previous experience working with schools/ teachers
• Knowledge or experience of university admissions
• Knowledge or experience in Widening Participation
• Medical knowledge or experience
• Experience working in the third sector
• Bid writing experience


Our values
We believe in helping people to be the best that they can be – that includes the people who work with, and work for us! We uphold our values of:
Excellence – we continually seek new, better ways of operating to reach as many people as we can without compromising on the quality of our programmes.
Innovation – we want to drive trust.
Equity – every person is treated fairly and with respect and trust.
Improvement – we want to get the best out of ourselves and each other and continually challenge ourselves and those around us in a way that will focus on our assets and help them to grow.
Collaboration – we listen to our beneficiaries and stakeholders as they are the people who know how we can make the biggest difference.


The role
As this is a new role, the hours are flexible and are likely to increase over time. Initially, terms are as follows:
• Salary £22,000 per annum pro rata (£334.62 per month) with additional hours paid monthly
• Minimum of 8 hours a week, term time only
• Option to join employer-contributed pension scheme
• Flexible hours
• Home working
• Supportive, friendly team
• The opportunity to transform the NHS of tomorrow and support the aspirations of young people from all backgrounds
• Potential to progress in terms of role, hours and responsibilities as the organisation grows.

If you are interested in the role, please email a CV and covering letter to [email protected] by Friday 7th January. Interviews (online initially) will be conducted w/b 10th January. If you have any questions about the role, please get in touch.

BMA Endorsement – Transforming Opportunities Today and Outcomes Tomorrow

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At The Armitage Foundation, we believe that by changing the opportunities for young people today, we can transform the outcomes and opportunities for patients and medical professionals alike. We envision a community of medical professionals, working together to help each other to not only be the best that they can be, but to bring the best outcomes to all patients and colleagues, regardless of their backgrounds. Among our valued partnerships, we are proud to be endorsed by the BMA, the UK’s trade union and professional body for doctors in the UK, which represents more than 160,000 doctors and medical students

BMA Endorsement
Our mission closely aligns with the BMA’s objects: to promote the medical and allied sciences, maintain the honour and interests of the medical profession, and promote the achievement of high-quality healthcare. We were, therefore, delighted to receive endorsement from the BMA Council Chair, Dr Chaand Nagpaul:

The Armitage Foundation’s vision of an NHS workforce that reflects the diverse society it deserves and where any student possessing the capability and passion for becoming a doctor is able to do so, regardless of their background, is one that is also shared by the BMA. Their school-based programmes, designed to help students from year 8 through to year 13, equip the students with the skills, knowledge and confidence they need to gain a place at medical school. This long-term intervention approach ensures that students from underrepresented backgrounds get the opportunity to achieve their full potential.

We strongly support The Armitage Foundation’s work and hope to be able to work together to achieve our common objectives around widening participation in medicine.

Dr Chaand Nagpaul
BMA Council Chair

Promoting Doctor-Patient Trust
Promoting medical school applications from a diversity of ethnic and socioeconomic backgrounds will, in the long term, mean that patients will be able to see doctors to whom they can relate. This will lead to increased trust between patient and their doctor, which will promote improved uptake of recommended actions and, hence, outcomes.

While there has been limited investigation into the importance of having a diverse workforce of doctors, studies are beginning to show the importance of ethnic diversity on patient outcomes; one study on male patients showed that black men were more likely to undergo tests and treatment if advised by black male physicians than white male physicians. The American study concluded that a diverse medical workforce could reduce the black-white gap in cardiovascular mortality by 19% and the gap in black-white male life expectancy by 8% (BMJ – 28/09/2018). There is no doubt that, just as some women prefer to see a female physician and some men prefer to be treated by a male, some people will feel more comfortable seeing a doctor who they think can relate to them culturally or socially.

Improving Diagnosis For All Skin Colours
Improved patient outcomes will extend beyond patients being to see doctors to whom they relate; improved representation of all societies will lead to the consideration of diverse perspectives, as highlighted by medical student, Malone Mukwende’s, experience. During his studies at St George’s, University of London Mukwende noticed the lack of diversity in medical literature and education. When trying to understand how symptoms such as bruising, blue lips, and rashes, presented on dark skin, it became clear that there were limited – or no- standard references, and people were not taught the correct terminology when referring to symptoms on darker skin. Malone partnered with Dr. Peter Tamony to create a universal tool that would help medical professionals to understand symptoms and terminology for all skin colours. Mind the Gap: A Handbook of Clinical Signs in Black and Brown Skin aims to bridge the outcomes gap for patients with darker skin by making medical professionals better informed.

Building a Stronger Community
We believe that anyone who has the desire and ability to become a doctor should be able to do so. By bringing equity to the medical admissions process, we hope to support the BMA’s mission to give a voice and equal representation to doctors from all backgrounds. It is our hope that groups that are currently underrepresented among doctors will, in time, have better representation in their workforce. This will help to give a voice to minority groups, as medical professionals offer each other solidarity, understanding and support in their treatment of patients and their interactions with each other.

We are proud to have received endorsement from the BMA and very much look forward to working with them in the future.

To find out more about what we do, sign up to our newsletter – to support our work, please consider making a regular donation – even £5 a month can help to transform the NHS of tomorrow.

Facing Covid-19

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At The Armitage Foundation, we are no strangers to challenges; after all, our charity was created to help people overcome the challenges that they face in pursuing their ambition of studying medicine. However, a global pandemic is a challenge that we, like most of the rest of the world, didn’t ever expect to see. And we certainly never imagined that Leanne and her cohort of medical students would be joining an NHS in crisis!

This academic year was an exciting one for us; aside from it being Leanne’s final year at University, it was the last year that Leanne’s Amazing Medics would be run in two London schools, and we were excited to launch the pilot of Armitage Juniors and Armitage Seniors in a third London school. These programmes were prematurely cut short when schools were closed in March 2020 and due to online safeguarding issues, we are currently yet to find a satisfactory way to provide the programme participants with ongoing support this year.

But, we are not disheartened! The Armitage Foundation has been on a tremendous journey over the past couple of years and it has been challenging to keep up with the events, awards and media coverage that our work, and Leanne’s achievements, have attracted. We are, therefore, going to do something that we promote in our programmes: we are taking a negative situation and turning it into a positive. This period will enable us to focus on The Armitage Foundation on a larger, strategic level. We plan to spend the next few weeks working on:

  • Programme development – while our talented and committed Armitage Ambassadors are relatively free of study commitments, led by Leanne, they will be perfecting the full pilot programmes so that they are ready for the restart of the pilots.
  • Building relationships – thus far, The Armitage Foundation’s partnerships have developed organically. In order to move on, we will be seeking to develop partnerships with mentors, universities and funding organisations to take us to the next level.
  • Marketing – we will make the most of any down time with some website and marketing development so that as many people as possible will find out about The Armitage Foundation, who we are, and what we do.
  • Fundraising – once our pilot programmes are complete, we are confident that our programme funding will be sustainable. Until then, we are in need of funds to take us through these unexpected time. So, we will place a major focus on fundraising from trusts and individuals. If you are an individual and would like to make a regular monthly donation, please click here. If you are connected to a trust or foundation and you could help – please get in touch.

As soon as we know more about when universities and schools will resume some form of normality, we will be seeking to recruit and train a new team of Armitage Ambassadors, as well as welcoming existing Ambassadors back for another year. We will restart the final programmes of Leanne’s Amazing Medics and relaunch our pilots bigger and better than ever!

These are challenging times for us as an organisation but we are confident that we can use this time to our advantage, and, with the support of our new board of trustees, develop funding and strategy for a sustainable future. If you would like to support us on this journey, we’d love to hear from you!

Leanne’s Story

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If my mind can achieve it and my heart can believe it, I know I can achieve it

Jesse Jackson

People often ask us what motivates The Armitage Foundation to want change so badly, so this is my story! It is a testament to the Jesse Jackson quote above: my mind believed it, my heart conceived, and guess what? I achieved it!!

I decided that I wanted to become a trauma surgeon when I was 15 years old. One day, I was travelling home when I saw a helicopter had landed on a grass field in the middle of an estate close to my home. Anyone who knows me well knows that I ABSOLUTELY LOVE HELICOPTERS! So it was not long before I found myself squeezing through the crowd to get as close as possible to the action. My joy soon evaporated when I realised why the helicopter had landed: a young man had been stabbed and was probably on the brink of death. That evening I went home feeling really grieved inside. Although I did not see the young man, because an ambulance had taken him, I felt sad in my heart. I was also frustrated because I felt so very helpless. I wondered who out of the crowd of witnesses was going to try to make a change? Who was going to stand up for others in my community and help stop the knife and gun crime issue that was plaguing the city…?

After some thought, I decided I would aspire to become a trauma surgeon. WHY? Because I believed it would give me a platform to go into environments where young men may have been affected by knife and gun crime, in the hope of inspiring them to aspire to be and do better. This is where my story began.

Deciding that I wanted to become a trauma surgeon might have been considered very daring for someone coming from my background. Like many students, I faced a lot of challenges, not least the ones listed below:

  • Growing up in a single-parent home
  • Growing up on a council estate
  • Coming from a family of zero medics
  • My mother was not well educated
  • Only one of my mother’s five children had been to University
  • My own self-doubt and false perceptions – even today I suffer from imposter syndrome
  • The doubt of people close to me – nobody believed I could achieve my dreams because “people like me” didn’t become doctors
  • Friends who weren’t that focused – they were too busy having fun to work hard!

Despite these challenges, I decided that I would stay committed to the vision in my heart. My first step was to google what I needed to do to become a doctor. After doing so, I realised I needed to get good grades at GCSE. I therefore set myself the goal of achieving 10A*’s and to my surprise, that is what I got!

Following my GCSE success, I was awarded a 100% Bursary (like a scholarship) to study my Sixth Form education at Mill Hill – a boarding school in North London . After my first year of A levels, I applied for medical school and unfortunately was rejected from every school I applied to with no interviews!

I was devastated that nobody would give me an interview. My heart felt crushed at this disappointment because it appeared as though the dream I had was faltering. However, I stayed committed to my vision! I took a Gap Year and reapplied to medical school.

This time round, I received 3 medical offers and decided to study at St George’s University of London. I was delighted to graduate in April 2020 – I am now Dr Leanne Armitage! I am not quite sure whether I still want to be a trauma surgeon, but this just makes my journey more exciting! I feel that I am on the path to success and on my way, I am determined to help other students like me get into medical school.

If you would like to know more about The Armitage Foundation, please get in touch. If you would like to support our work, please visit our donations page. We are incredibly grateful for any financial support, no matter how big or small; even a regular, monthly donation of £5 will help us to transform lives today and the NHS tomorrow.

Welcoming Trustees in 2020

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As a growing organisation, The Armitage Foundation has, until now, flourished under the supervision of three trustees: Co-founders Leanne Armitage and Daniel Huf (Chair of Trustees) and Veronica Martin.

At the end of 2019 we were thrilled to welcome three committed new trustees to join our team:

Mo Akindolie is a consultant in Ambulatory Paediatrics at King’s College Hospital in London and Clinical Director for Children and Young People with the Healthy London Partnership. Mo graduated from the University of Newcastly upon Tyne and has played a significant role in redesigning paediatric services to meet local needs. Mo is a keen advocate for equity in the medical profession and will help to champion the least privileged to reach their potential.

Georgina Wells is CEO at Wellsaw Professional Services and Deputy Head for Collective Leadership at the Cabinet Office. Georgina is an entrepreneur with more than 10 years’ experience in strategy and business development and stakeholder management in the public, private and third sectors. She has been a valuable mentor to Leanne and Daniel for the past two years and we are thrilled that she will continue to support The Armitage Foundation through its next growth phase.

Cerys Ledger is an experienced accountant and Deputy Director of Finance at St George’s University of London. Cerys’s experience monitoring performance and finances in the public centre will be invaluable in ensuring the sustainable growth of the organisation.

We are delighted that Cerys, Georgina and Mo have joined our team and are confident that their expertise will help us to grow sustainably as we look to expand our provision to improve outcomes for students from underrepresented backgrounds across the country.