Miriam, as long as you brought up the subject of access to the Covid
vaccine, it turns out that many blind people, including me, have no access
to it since it is difficult to impossible for them to make appointments
online to get vaccinated because many appointmen scheduling web sites are
not accessible to screen readers, as the following article explains:
[tech-vi Announce List] COVID vaccine websites create inequity for the blind
- ModernHealthcare.com
"Screen reader" - Google News - Thursday, February 25, 2021 at 12:33 PM
COVID vaccine websites create inequity for the blind - ModernHealthcare.com
Many COVID vaccination registration and information websites at the federal,
state and local levels violate disability rights laws, hindering the ability
of blind people to sign up for a potentially lifesaving vaccine, a KHN
investigation has found.
Across the country, people who use special software to make the web
accessible have been unable to sign up for the vaccines or obtain vital
information
about COVID-19 because many government websites lack required accessibility
features. At least 7.6 million people in the U.S. over age 16 have a visual
disability.
WebAIM, a nonprofit web accessibility organization, checked COVID vaccine
websites gathered by KHN from all 50 states and the District of Columbia. On
Jan. 27, it found accessibility issues on nearly all of 94 webpages, which
included general vaccine information, lists of vaccine providers and
registration
forms.
In at least seven states, blind residents said they were unable to register
for the vaccine through their state or local governments without help. Phone
alternatives, when available, have been beset with their own issues, such as
long hold times and not being available at all hours like websites.
Even the federal Centers for Disease Control and Prevention's Vaccine
Administration Management System, which a small number of states and
counties opted
to use after its rocky rollout, has been inaccessible for blind users.
Those problems violate the Rehabilitation Act of 1973, which established the
right to communications in an accessible format, multiple legal experts and
disability advocates said. The federal Americans with Disabilities Act, a
civil rights law that prohibits governments and private businesses from
discriminating
based on disability, further enshrined this protection in 1990.
Doris Ray, 72, who is blind and has a significant hearing impairment, ran
into such issues when she tried to sign up for a vaccine last month with the
CDC's system, used by Arlington County in Virginia. As the outreach director
for the ENDependence Center of Northern Virginia, an advocacy center run by
and for people with disabilities, she had qualified for the vaccine because
of her in-person work with clients.
When she used screen-reading technology, which reads a website's text aloud,
the drop-down field to identify her county did not work. She was unable to
register for over two weeks, until a colleague helped her.
"This is outrageous in the time of a public health emergency, that blind
people aren't able to access something to get vaccinated," Ray said.
Mark Riccobono, president of the National Federation of the Blind, wrote to
the U.S. Health and Human Services Department in early December, laying out
his concerns on vaccine accessibility.
"A national emergency does not exempt federal, state, and local governments
from providing equal access," he wrote.
Dr. Robert Redfield, who was then leading the CDC, responded that the
interim vaccine playbook for health departments included a reminder of the
legal
requirements for accessible information.
CDC spokesperson Jasmine Reed said in an email that VAMS is compliant with
federal accessibility laws and that the agency requires testing of its
services.
But more than two months into a national vaccine campaign, those on the
ground report problems at all levels.
Some local officials who use VAMS are aware of the ongoing problems and
blame the federal government. Arlington Assistant County Manager Bryna
Helfer said
that because VAMS is run by the federal government the county cannot access
the internal workings to troubleshoot the system for blind residents.
Connecticut Department of Public Health spokesperson Maura Fitzgerald said
the state was aware of "many accessibility issues" with VAMS. She said it
had
staffed up its call center to handle the problems and was working with the
federal government "to improve VAMS and enable the functionality that was
promised."
Deanna O'Brien, president of the National Federation of the Blind of New
Hampshire, said she had heard from blind people unable to use the system.
New
Hampshire's health department did not answer KHN questions about the
problems.
Blind people are particularly vulnerable to contracting the COVID virus
because they often cannot physically distance themselves from others.
"When I go to the grocery store, I do not have the option of walking around
and not being near a person," said Albert Elia, a blind attorney who works
with the San Francisco-based TRE Legal Practice on accessibility cases. "I
need a person at the store to assist me in shopping."
There is no standardized way to register for a COVID vaccine nationwide - or
fix the online accessibility problems. Some states use VAMS; some states
have
centralized online vaccination registration sites; others have a mix of
state-run and locally run websites, or leave it all to local health
departments
or hospitals. Ultimately, state and local governments are responsible for
making their vaccination systems accessible, whether they use the VAMS
system
or not.
"Once those portals open, it's a race to see who can click the fastest,"
Riccobono said. "We don't have time to do things like file a lawsuit,
because,
at the end of the day, we need to fix it today."
Common programming failures that make sites hard to use for the visually
impaired included text without enough contrast to distinguish words from the
page's
background and images without alternative text explaining what they showed,
the WebAIM survey showed. Even worse, portions of the forms on 19 states'
pages
were built so that screen readers couldn't decipher what information a user
should enter on search bars or vaccine registration forms.
The new vaccine pages had more errors than states' main coronavirus pages
but slightly fewer than state government websites in general, said WebAIM
Associate
Director Jared Smith.
In Alameda County, California, when Bryan Bashin, 65, who is blind and CEO
of the LightHouse for the Blind and Visually Impaired in San Francisco,
tried
to sign up on Feb. 9 for his vaccine appointment, he encountered multiple
hurdles. The appointments slipped away. That night he received an email from
the city of Berkeley offering vaccinations. But after two hours struggling
with its inaccessible website, all the slots were again taken, he said in an
email.
He was only able to get an appointment after his sighted sister signed him
up and has since received his first shot.
"It's an awful bit of discrimination, one as stinging as anything I've
experienced," Bashin said.
Susan Jones, a blind 69-year-old in Indianapolis, had to rely on the Aira
app, which allows a sighted person to operate her computer remotely, when
she
tried to register for her vaccine appointment.
"I resent that the assumption is that a sighted fairy godmother ought to be
there at all times," said Sheela Gunn-Cushman, a 49-year-old also in Alameda
County, who also had to rely on Aira to complete preregistration for a
vaccine.
Emily Creasy, 23, a visually impaired woman in Polk County, Oregon, said she
tried unsuccessfully for a month to make the scheduling apparatus work with
her screen reader. She finally received her first shot after her mother and
roommate helped her.
Even Sachin Dev Pavithran, 43, who is blind and executive director of the
U.S. Access Board, an independent agency of the federal government that
works
to increase accessibility, said he struggled to access vaccine registration
information in Logan, Utah.
The Indiana Health Department, Public Health Division of Berkeley and
Oregon's Polk County Public Health did not respond to requests for comment.
Utah's
Bear River Health Department did not answer questions on the issue.
After Alameda County received complaints from users that its site was not
compatible with screen readers, officials decided to move away from its
preregistration
technology, Health Department spokesperson Neetu Balram said in
mid-February. The county has since switched to a new form.
If vaccine accessibility issues are not fixed across the country, though,
lawsuits could come next, Elia said. Members of the blind community recently
won landmark lawsuits against Domino's Pizza and the Winn-Dixie grocery
chain after being unable to order online.
And, Elia said, "this is not ordering a pizza - this is being able to get a
potentially lifesaving vaccine."
Kaiser Health News
is a national health policy news service. It is an editorially independent
program of the Henry J. Kaiser Family Foundation, which is not affiliated
with
Kaiser Permanente.