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State COVID-19 Websites Still Fail to Meet Accessibility Standards

Sep 27, 2023


According to a new study from North Carolina State University (NCSU), state websites created to share information about the COVID-19 pandemic fail to meet basic accessibility guidelines — a serious concern and potential violation of Title II of the Americans with Disabilities Act (ADA).

NCSU researchers began analyzing state COVID-19 websites in 2021. Every U.S. state and territory has at least one pandemic information webpage to communicate vital information about COVID-19 testing sites, vaccine availability, and health recommendations.

In 2021, the NCSU team found that none of those websites met the Level AA standards of the Web Content Accessibility Guidelines (WCAG), which are widely considered the international standards for accessibility.

And in 2023, the situation hasn’t improved: An automated analysis found that none of the public-facing COVID-19 websites cleared all WCAG Level AA requirements.


The COVID-19 pandemic highlighted the importance of web accessibility


In November 2020, the Bureau of Internet Accessibility (BOIA) published a call to make all COVID-19 vaccine information accessible. We asked state and federal agencies to follow WCAG and treat accessibility as a priority — but unfortunately, many agencies didn’t take appropriate steps.

Digital accessibility is always crucial, but when a website provides crucial information for broad audiences, it’s an even greater concern. 

“Everyone should be able to access this important health information,” says Yingchen He, co-author of a paper on the 2023 study and assistant professor of psychology at NCSU. 

“People need to know how to protect themselves, how to access vaccines and what the current public health recommendations are. Right now, many state and territorial governments are not meeting these needs.”

Without accessible resources, people with disabilities may have trouble finding adequate medical care. The Centers for Disease Control and Prevention (CDC) has published accessibility guidance for clinics, but research indicates that clinics and health authorities routinely fail to consider accessibility when establishing vaccination programs.

That may lead to costly consequences for organizations. In December 2022, the Department of Justice (DOJ) reached a settlement agreement with supermarket chain Hyvee, Inc., which required the chain to address potential ADA violations on its vaccination appointment portals. 

Related: Did COVID-19 Improve Web Accessibility Awareness?


State websites should prioritize accessibility for public-facing content


Under Title II of the ADA, all digital content must be made accessible for users with disabilities. That applies to both public-facing websites and content used by employees (for example, PDFs and other documents created for internal use). 

For public-facing content, the issue is especially crucial: Millions of people depend on state and federal health websites for accurate information. If that information isn’t accessible, it creates issues for the estimated 61 million U.S. adults with disabilities.

And in many cases, content can meet WCAG easily — provided that content creators think about accessibility from day one. For COVID-19 websites, common barriers include: 


  • Missing alternative text (also called alt text), which explains the content and function of images, graphs, and other visual content for users who cannot (or choose not to) perceive content visually.
  • Poor keyboard accessibility, which impacts users who use a keyboard alone (with no mouse) to browse the internet. Screen readers and many other assistive technologies may work best with a keyboard alone.
  • Strict time limits, which can prevent some users from completing vaccine registrations and other essential processes.
  • Using color alone to convey information. For example, writing “click the green button to start the vaccine registration process.” 
  • Using low-contrast text, which may be difficult to read for people with color vision deficiencies. NCSU’s 2023 study found that contrast issues have actually increased on state websites since 2021 — more websites fail to meet WCAG’s requirements for color contrast ratios. 


All of these issues are completely avoidable. If web developers and designers think about accessibility from the earliest stages of development, they can meet WCAG without much additional work. 

But when accessibility barriers become part of a published website, it’s essential to fix those issues. By regularly testing content against WCAG Level AA — and following WCAG’s guidance for fixing accessibility problems — we can start addressing the internet accessibility gap.

To learn how to develop inclusive web content, download our free eBook: The Definitive Website Accessibility Checklist.

For guidance with a specific website or web accessibility issue, send us a message to connect with an expert.

Use our free Website Accessibility Checker to scan your site for ADA and WCAG compliance.

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