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Many sites coveted for vaccination information and records at federal, state and local levels violate disability rights laws, preventing blind people from signing up for a life-saving vaccine, a KHN investigation concluded.
Across the country, people using special software to make the web accessible have been unable to sign up for vaccines or get vital information about covid-19 because many government websites do not have the required accessibility features. In the United States, at least 7.6 million people over the age of 16 are visually impaired.
WebAIM, a non-profit web accessibility organization, has verified coveted vaccine sites gathered by KHN from all 50 states and the District of Columbia. On January 27, he found accessibility problems on almost all 94 web pages, which included general information about vaccines, lists of vaccine suppliers and registration forms.
In at least seven states, blind residents said they could not register for the vaccine through their state or local governments without assistance. Telephone alternatives, when available, have their own problems, such as long waiting times and not being available all the time, such as websites.
Even the federal Centers for the Vaccine Administration Management System at the Centers for Disease Control and Prevention, which a small number of states and counties have chosen to use after their rocky deployment, has been inaccessible to blind users.
These problems violate the 1973 Rehabilitation Act, which established the right to communication in an accessible format, said several legal experts and disability advocates. The federal law of Americans with disabilities, a civil rights law that prohibits governments and private companies from discriminating on the basis of disability, further enshrined this protection in 1990.
Doris Ray, 72, who is blind and has a significant hearing impairment, had these problems when she tried to apply for a vaccine last month with the CDC system, used by Arlington County, Virginia. As an extension director at the North Virginia ENDependence Center, a defense center run by and for people with disabilities, she qualified for the vaccine because of her personal work with clients.
When she used screen reading technology, which reads the text of a website aloud, the suspended field to identify her municipality did not work. She was unable to register for more than two weeks, until a colleague helped her.
“This is outrageous in times of public health emergency, that blind people do not have access to something to get vaccinated,” said Ray.
Mark Riccobono, president of the National Federation of the Blind, wrote to the United States Department of Health and Human Services in early December, outlining his concerns about the vaccine’s accessibility.
“A national emergency does not exempt the federal, state and local governments from providing equal access,” he wrote.
Dr. Robert Redfield, who then led the CDC, responded that the draft vaccine manual for health departments included a reminder of the legal requirements for accessible information.
CDC spokesman Jasmine Reed said in an email that VAMS complies with federal accessibility laws and that the agency requires testing of its services.
However, after more than two months of a national vaccination campaign, those at the site report problems at all levels.
Some local officials using VAMS are aware of the ongoing problems and blame the federal government. Bryna Helfer, assistant manager for Arlington County, said that since VAMS is administered by the federal government, the county cannot access the inner workings of troubleshooting the system for blind residents.
Connecticut Department of Public Health spokeswoman Maura Fitzgerald said the state was aware of “many accessibility problems” with VAMS. She said she had hired a call center team to deal with the problems and was working with the federal government “to improve VAMS and enable the promised functionality”.
Deanna O’Brien, president of the New Hampshire National Blind Federation, said she heard of blind people unable to use the system. The New Hampshire health department did not respond to KHN’s questions about the problems.
The blind are particularly vulnerable to contracting the greedy virus because they often cannot physically distance themselves from others.
“When I go to the supermarket, I don’t have the option of walking around and not being around a person,” said Albert Elia, a blind lawyer who works with TRE Legal Practice in San Francisco on accessibility cases. “I need someone at the store to help me with shopping.”
There is no standardized way to register for a covid vaccine across the country – or fix 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 sites, or leave everything to local health departments or hospitals. Ultimately, state and local governments are responsible for making their vaccination systems accessible, whether or not they use the VAMS system.
“After these portals are opened, it’s a race to see who clicks the fastest,” said Riccobono. “We don’t have time to do things like file a lawsuit, because, in the end, we need to fix it today.”
Common programming flaws that make websites difficult to use for the visually impaired include text without enough contrast to distinguish words from the page background and images without alternative text explaining what they show, the WebAIM survey showed. Worse still, parts of the forms on the pages of 19 states were created so that screen readers could not decipher what information a user should enter in the search bars or vaccine registration forms.
The new vaccine pages had more errors than the states’ main coronavirus pages, but slightly less than the state government websites in general, said WebAIM’s associate director, Jared Smith.
In Alameda County, California, when Bryan Bashin, 65, who is blind and CEO of LightHouse for the Blind and Visually Impaired in San Francisco, tried to apply on February 9 for his vaccination appointment, he encountered several obstacles. The commitments are gone. That night, he received an email from the city of Berkeley offering vaccines. But after two hours of struggling with his inaccessible website, all vacancies have been filled again, he said in an email.
He only got an appointment after his psychic sister signed him up and has since received his first injection.
“It is terrible discrimination, as painful as anything I have ever experienced,” said Bashin.
Susan Jones, a 69-year-old blind woman from Indianapolis, had to rely on the Aira app, which allows a sighted person to operate her computer remotely when she tried to register for the vaccine appointment.
“I resent the assumption that a fairy godmother with vision should be there all the time,” said Sheela Gunn-Cushman, 49, also in Alameda County, who also had to rely on Aira to complete the pre-registration vaccine.
Emily Creasy, 23, a visually impaired woman in Polk County, Oregon, said she tried unsuccessfully for a month to get the scheduling device to work with her screen reader. She finally got her first chance after her mom and roommate helped her.
Even Sachin Dev Pavithran, 43, who is blind and the executive director of the US Access Board, an independent federal government agency that works to increase accessibility, said he has difficulty accessing vaccine registration information in Logan, Utah.
The Indiana Department of Health, the Berkeley Division of Public Health and Oregon’s Polk County Public Health did not respond to requests for comment. Utah’s Bear River Department of Health did not answer questions about the matter.
After Alameda County received complaints from users that its website was not compatible with screen readers, authorities decided to abandon its pre-registration technology, Health Department spokesman Neetu Balram said in mid-February. . Since then, the county has changed to a new form.
If the vaccine’s accessibility problems are not resolved across the country, however, lawsuits may follow, Elia said. Members of the blind community recently won historic lawsuits against Domino’s Pizza and the supermarket chain Winn-Dixie, after failing to place orders online.
And, Elia said, “that’s not ordering a pizza – it’s being able to get a life-saving vaccine.”
Kaiser Health News (KHN) is a national health policy news service. It is an independent editorial program by the Henry J. Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.
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