In October 2020, the National Academies of Sciences, Engineering, and Medicine released a preliminary framework describing the allocation process for a COVID-19 vaccine. The plan attempts to use ethical and procedural principles to allocate a vaccine effectively — but the framework, as written, may not adequately prioritize people with disabilities.
The framework describes a four-phase plan for distributing the vaccine. While people with disabilities living in group homes are mentioned in the second phase, the document doesn’t otherwise account for disability status — possibly due to a lack of concrete data on how people with disabilities have been specifically affected by the pandemic.
While the Centers for Disease Control and Prevention (CDC) note that disability alone may not be related to higher risk for severe COVID-19 symptoms, certain disabilities and chronic medical conditions can increase risks significantly. There is currently no systematic reporting of COVID-19 mortality, outcomes, testing, or infection by disability status, and this lack of reporting has contributed to the challenges that people with disabilities have faced during the pandemic.
Here’s what we do know: People with disabilities face barriers when getting COVID-19 tests, when seeking medical treatment, and when receiving information about the disease. Logically, some of these barriers will persist when a vaccine becomes available. Most people with disabilities don’t live in group homes, so they wouldn’t be vaccinated under Phase 1 or 2 of such a plan; however, many of those people interact with caregivers, physicians, and other individuals regularly, and would realistically have a higher risk of infection than people with no disabilities.
And the data limitations highlight a significant accessibility issue exposed by the COVID-19 crisis: Accessibility isn’t usually treated as a priority, even in public health science. This causes unnecessary barriers; people with physical disabilities may not be able to visit certain vaccination sites, for instance, and people with vision or hearing disabilities may not be able to communicate effectively with their physicians when wearing masks. By failing to account for the wide range of ways that disabilities can affect daily life, pandemic policies often overlook real people.
Restoring equity starts with making COVID-19 information accessible
We can’t provide a comprehensive list of ways that policymakers, health organizations, and private businesses can correct the oversights that have affected people with disabilities during the pandemic — that’s an extraordinarily complex topic — but by making COVID-19 information accessible, organizations of all sizes can take an important step forward. That means regularly assessing all pandemic-related content and prioritizing all types of real-world users. For example:
Provide alternatives to visual content
Many websites have presented COVID-19 information with detailed charts, videos, infographics, and other visual content. Visually striking content can get readers' attention, but it can also create barriers for people with disabilities.
All information related to COVID needs to be made accessible, regardless of whether that information is geared specifically towards people with disabilities, and visual content should follow proper guidelines. Put simply, almost anything that isn’t text should have a text alternative, and alternatives should be easily understandable.
Important forms need to be accessible, following WCAG standards
Admittedly, all forms should follow the Web Content Accessibility Guidelines (WCAG), which lay out essential rules for identifying and labeling text fields, allowing users to prevent timeouts and errors, and letting users input text with assistive devices. And, all forms should follow color contrast requirements.
No form should neglect these guidelines. However, health-related forms — such as applications for a hypothetical COVID-19 vaccine or pandemic assistance forms on a financial institution’s website — may have an especially urgent obligation to follow these best practices.
Every organization should treat accessibility as a priority when developing its pandemic response
The concerns surrounding the COVID-19 vaccine framework bring attention to a key concept of accessibility: It’s not a one-and-done process at any level. When policymakers approach important topics, disability status should be considered and directly addressed. When a website publishes new information, the site owner should ensure that the information is accessible for all readers — particularly when that information is related to a global pandemic. New pages should be tested, along with navigation elements, forms, and everything else that might affect the way that the user interacts with the content.
Accessibility barriers have become particularly worrisome during the current crisis, as they can prevent users from learning information, obtaining financial assistance, or even seeking medical treatment. These barriers aren’t always obvious to decisionmakers, which is why prioritizing accessibility is so important. Businesses, non-profits, and government institutions have a responsibility to provide their users with options, particularly when content is crucial.
