Covid Vaccine Websites Violate Disability Laws, Create Inequity for the Blind | Hacker News Reader

Covid Vaccine Websites Violate Disability Laws, Create Inequity for the Blind

khn.org

36 pointsalwillis56 comments

I do not want to wade into the "should these vaccination websites be made accessible" argument. I think they should be, full stop.

But, it isn't clear to me from this article the extent of the difficulty people are having, how many people are having issues, what those issues are, etc., and the overall tone of the piece seems light on information and heavy on righteous outrage. It's in that class of badly written articles that just wants people to be angry but not necessarily better informed.

Yeah what exact issues are being talked about? Also were any ADA laws broken, because that GREATLY impacts how I read into this story and where any problem (if any) may lie.

"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."

"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."

I'm a totally blind software developer. I used two sites to sign up for a vaccine. The first site was a covid vaccine specific website. I was unable to use it with my screen reader. I can't remember the exact issue but it was something to do with a popup my screen reader could not interact with to select a date. Luckily I had family who were able to fill out the form for me with in a couple hours of opening availability. I was fortunate that my family were not in frontline jobs and could be at a computer when I needed them to be. The second site was a mobile health clinic that was targeting disabled and at risk individuals. That worked fine because there goal was to get vaccines in arms and not worry about the technology. They used signup genius which had no accessibility issues for me. I understand that accessibility is not always easy. I don't expect Xbox Live cloud to somehow magically make first person shooter games accessible. There's no reason in 2021 that a site that does nothing but have you fill out a basic form with the ability to select a date and time should be unusable with screen readers.

Are there accessible games for consoles? or in general?

Very few, and only to a limited degree.

Right now, a lot of games provide partial accessibility for deaf players by including on-screen captions -- although many of them have insufficient captions for sound effects -- and some games provide accessibility for the colorblind with alternate color schemes or filters. That's about the full extent of accessibility support, AFAIK.

Accessibility for the blind is basically not even on the roadmap. Some games are barely playable by blind gamers (e.g. https://www.polygon.com/2016/1/4/10707692/blind-gamer-beats-...), but that's much more by accident than design.

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.

Just wondering, does the ADA require equal access, or a "reasonable accommodation", like a phone call center?

I agree that the websites should be made accessible to the visually (or otherwise) impaired, but does the ADA actually require it?

> not being available at all hours like websites

Hah! Back when this was written, it wasn't like websites were available at all hours (the vaccine rush crashed some) or had open time slots to book.

It's worth remembering that there is a substantial gray area about the extent to which the ADA applies to websites, even government ones. If WebAIM is finding violations with WCAG 2.1, there's even less of a legal basis. Much of the legal thinking is based on reading between the lines of DOJ letters and wildly different state/federal lawsuit rulings.

It's odd we haven't heard much about a current push from disability advocates to pass clearly worded web accessibility regulation in Congress now that there is a regulation friendly government in power.

It's a pretty good idea. Even a flawed set of standards would help to promote accessible web design and make it fast and inexpensive to make a website that more people can use beyond the ones used today.

Part of my work involves creating web UI, and the accessibility part of it is a bit annoying because I'm not very familiar with it.

But then I think about the people who have to rely on screen reader tools and then my irritation seems insignificant in comparison. Just do it, there's no excuse for having non-accessible web UI.

Also, if you're using either plain HTML or a library such as FluentUI that provides components with accessibility built-in, you get it without any effort. It's only when the designers make things complicated that it requires extra effort to make things accessible.

Custom dropdowns are the worst offenders. Most annoy keyboard users too and many are completely inaccessible.

Replicating the accessibility and keyboard functionality built into a basic <select> tag is really hard. I wish developers would just use the plain <select> or just make it a text entry field instead.

It's called a disability for a reason.

You don't just accuse things of "creating inequity" for merely existing. They should be accessible for all by all means but the title makes it seem like the only purpose of the websites is to vex blind people.

It might be worth adding "February 25, 2021" to the title. There's been a lot of complaining about the rollout in the US, but it mostly stopped when everyone who wanted a vaccine got one, and it became clear the US did one of the best jobs at getting people vaccinated after Israel and the UAE. If the people in this article couldn't call their doctors in May and get an appointment, they might have a point, but prioritizing getting people vaccinated and not worrying about details is part of why the US did such a good job. That, and securing contracts of lots of doses.

> Create Inequity for the Blind

I abhor this sentence.

Think about this, if you organize a 5k run with cash prizes, are you "creating inequity" for the people who can't run? Does this mean we should make it unlawful to organize events that promote sports, because some part of population can't take part in it?

If an application makes it easier for 99% of the people to vaccinate but does not make it easier for 1%, does it mean the application is bad?

Does existence of the application make it more difficult for the blind to vaccinate?

Also, think for a moment -- if everybody else vaccinates it also protects blind people, without having them to do anything.

Waiting for perfect solutions when a solution is needed is best way to paralyze any organization and have no solution at all.

This isn't a cash prize for a fun run, it's a bunch of government run websites that are meant to facilitate a necessary and potentially life saving service to all residents. By making these sites inaccessible, they make it harder to access the vaccine.

Article> 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.

> If an application makes it easier for 99% of the people to vaccinate but does not make it easier for 1%, does it mean the application is bad?

If that 1% is a protected class (disabled) then it's illegal.

What about phone lines? These should also be illegal because deaf people can't use them.

Deaf people access phone services through TTY/TDD. People who are deaf and blind can do the same with Braille.

Well, I see you are citing materials which you did not read / don't understand.

"Separate but equal was a legal doctrine in United States constitutional law, according to which racial segregation did not necessarily violate the Fourteenth Amendment to the United States Constitution, which guaranteed "equal protection" under the law to all people. Under the doctrine, as long as the facilities provided to each "race" were equal, state and local governments could require that services, facilities, public accommodations, housing, medical care, education, employment, and transportation be segregated by "race", which was already the case throughout the states of the former Confederacy. The phrase was derived from a Louisiana law of 1890, although the law actually used the phrase "equal but separate".[1]"

Nothing to do with disabilities.

It is plain stupid to think you can require all services to be equally available, in the same way, shape and form to both normal, blind and deaf people and disallow services that can't be enjoyed by all, equally.

Existence of blind people should not be a reason to disallow rock concerts.

Plain stupid, eh? The DOJ has disagreed with you as recently as 2011, but the ad hominem really seems to work for you.

https://www.aclu.org/blog/disability-rights/separate-not-equ...

And, again, a rock concert isn't equivalent to a government service. You've invented a notion that everybody needs to have the same exact experience, which is weird. The government needs to provision services equally to everybody. If they aren't funding their call centers for adequate access, then it isn't equal access.

But anyway, I go to dance parties with Deaf people (or did, before Covid) and they love music with lots of bass.

The most unusual tech support call I received was from a deaf person. I worked at an ISP that supported UUCP (at the time, mid-90s). The deaf person was familiar with UUCP and wanted to set up an acccount. I really feel sorry for the translator, having to listen to weird jargon involving eunichs with modems.

From here[1]:

> In the U.S., every phone company is required to connect persons who dial 711 to a [Telecommunications relay service] call center from a working number. In July 2007, the Federal Communications Commission ruled that the 711 requirement extended to VOIP telephony.

[1] https://en.wikipedia.org/wiki/Telecommunications_relay_servi...

> Think about this, if you organize a 5k run with cash prizes, are you "creating inequity" for the people who can't run?

By definition yes.

That's a useless definition then.

You are creating inequity by engaging here, because a mentally disabled person somewhere cannot follow.

I have a mental disability which tends to make me excessively verbose and to expect me to never communicate naturally would also create an inequity.

You forgot inequity for children and for ESL people as well who also have trouble following complex texts. I sometimes go out of my way to rephrase or edit what I say to be more accessible.

Inequity can only be eliminated by killing literally everybody on the planet, after which we're all equal because we're all dead. Equity as an ultimate moral good is utterly and totally moronic. This doesn't mean the concept of "equity" doesn't have merits as a sort of heuristic for what we should strive for. In this case, increasing the number of people able to be vaccinated for the collective good of the community and reducing the sense of exclusion that disabled people feel as well as helping them avoid death. Sort of a win/win really.

Title II of the ADA applies to public entities, federal, state and local. I'd argue that the government funded and mandated vaccine campaign falls under Title II.

Title III of the ADA applies to public accommodations. Vaccination websites run by private entities have a legal obligation to make their sites accessible to disabled users. Luckily for businesses, accessibility is commodified on many software stacks, and there are plenty of companies and professionals they can hire to make their sites accessible. Also, if they give it even a second of forethought, they can build their sites with accessibility in mind and save themselves time and money in the future.

Or they can save even more money by not making the site in the first place!

Seems like a great opportunity for a competitor to get easy market share, then.

I'm sorry, this is a very bad take and analogy. A run inherently excludes people who cannot run. But a website need not inherently exclude the blind; websites are accessible to the vision impaired by default and it takes extra work to render them inaccessible. We can and should do better.

> websites are accessible to the vision impaired by default and it takes extra work to render them inaccessible

Is this really the case? If I build a website that entirely consists of a WebGL canvas, E.G. for a 3d graphics demo, I doubt screen readers would be able to make sense of it. But I didn't necessarily do any extra work to impair this usage, it was just a byproduct of the tools I used.

> for a 3d graphics demo

Presumably if you’re using WebGL for 3D graphics, it’s for something visual that can’t be seen by the blind, in which case you could have an alternative (or quite literally an “alt” tag) text version accompanying it.

I know you picked that example arbitrarily. But the GP’s point about “extra work to render them inaccessible” is, by and large, true. HTML by default is accessible.

"HTML, by default, is accessible" is at best a massive oversimplification. Arranging react elements in a certain way can break them. If you're writing out <div>s and tables like it's 1999 then sure, I'll take your word that this usually works with screen readers. But it's not 1999 anymore. It's a non-trivial task to make a modern website accessible to screen readers. My past workplaces had dedicated accessibility teams ensuring that the site and mobile apps were usable with a screen reader.

The point is that "websites are accessible to the vision impaired by default and it takes extra work to render them inaccessible" drastically trivializes the work it takes to make a moderately complex web accessible. And it falsely accuses those who don't have the resources to do this of deliberately making the site inaccessible.

> If I build a website that entirely consists of a WebGL canvas, E.G. for a 3d graphics demo

If all you're trying to do is make a website that lets people schedule appointments, then all of that shit is ludicrous "extra work."

Other people in this thread (and in our world) have taken a different interpretation, arguing that people should be forbidden from making new public services, including online publishing, that don't work for users with some disability. (For example, someone else in this thread said that web sites need to be annotated with accessibility information in order to facilitate interoperability with assistive software. In that account, that is extra work that someone might otherwise not do, rather than just refraining from breaking something.)

The popularity of versions this position suggests to me that there is a need for analogies and arguments that defend the idea that you should, in fact, be able to do stuff that some people will benefit from/be able to participate in and others can't/won't.

People seem to be confused here. What’s required is accommodation not equivalency. The important bit is things like color blindness can often but not always be accommodated.

Government websites need to accommodate the blind where possible, but that doesn’t prevent them from making a video game which they are unable to play. Similarly, companies can discriminate if someone is unable to preform core job functions after reasonable accommodation. Aka, no blind school bus drivers.

It’s because Covid information is just text and basic forms that they have the obligation. The requirements for 508 compliance are really quite basic, where projects trip up is treating it as some sort of tacked on requirement rather than basic functionality. Spending months on style choices etc then trying to tack on compliance when it’s “done.”

My 2 cents has always been it’s really up to the business. The business should do what it needs to maximize profit. If catering to the 0.3% of people who are vision impaired helps to that end, go for it. In this case, the 99.7% of people who can use the site are the target audience — and that’s good enough.

I’m not at all unsympathetic to the blind. I just think it’s a client problem and needs a client side solution.

I have severe allergies, ones where I could die if I ingest very little of multiple common foods. I NEVER expect a restaurant to cater to me as adjusting to my diet would put them at a competitive disadvantage. It’s expensive, time consuming and it’s a minuscule percentage of their customers.

Instead I carry an epipen and use my judgement or am responsible for myself. Sometimes that means I call ahead, don’t eat, w.e.

In this case, I’m sure the blind individuals can figure out how to get a vaccine. I’m sure their doctors will help and provide guidance. I doubt most of my friends and family got their vaccines without even knowing this site exists.

> The business should do what it needs to maximize profit

It’s a good thing this has never had unintended negative consequences.

Laws matter more than your 2 cents. And governments aren't businesses.

Accessible web sites exist. It isn't a client problem.

You are at least a bit unsympathetic.

>if you organize a 5k run with cash prizes, are you "creating inequity" for the people who can't run?

Yes.

>Does this mean we should make it unlawful to organize events that promote sports, because some part of population can't take part in it?

No.

>If an application makes it easier for 99% of the people to vaccinate but does not make it easier for 1%, does it mean the application is bad?

>Does existence of the application make it more difficult for the blind to vaccinate?

Creating a solution that satisfies the majority will reduce the demand to create any solution including one that the blind can use on their own. 99% being satisfied does not mean the 1% will not complain since it is one of the most effective means of pressuring for a solution that makes it easier for that 1% to vaccinate. 1% of the US is MILLIONS of people. Also since vision issues correlate to age, and age correlates to susceptibility to COVID, it's a particularly BAD for these particular millions to have hurdles to overcome regarding access.

>Waiting for perfect solutions when a solution is needed is best way to paralyze any organization and have no solution at all.

It's downright trivial for a government to require a baseline of accessibility for a website and there was more than a year and a half of lead time in this scenario with an insanely large budhet. We're not talking about a website shoved out the door 2 weeks after the pandemic was announced to help the public made by a guy in his basement. This is a website where accessibility was always a paramount concern, it honestly wouldn't matter a whit if the site was clunky, ugly, made with the latest frameworks, etc, but it was REALLY important that it was accessible given lack of accessibility has a body count attached to it.

Those disability advocates need to watch their tongue though and respect how great of a job these web developers did! Frankly they owe them their lives. They should be kneeling in gratitude and recognize that an ADA non-complaint website they can't use should be recognized as a success. All those laws they protested to get so this wouldn't happen can and should be ignored, and as this thread says, we can just add accessibility down the road.

If your solution is to assume everyone else will get the vaccine accept for blind people because the websites are inaccessible when are you going to pass laws mandating the vaccine? With out these laws we may never reach true heard immunity and blind people will never be as safe as people who were able to get the vaccine. I realize this is a strawman argument since were at the point where blind people should be able to get help from other sources besides websites now that the initial rush for vaccination has died down. I feel comfortable arguing this point though because assuming that society in general will always do the right thing so it's ok to exclude certain segments from being able to be proactive in helping them selves is crap. As someone who's totally blind I had no way of knowing if people were socially distancing, wearing masks, etc. I am incredibly fortunate that I had strong family support through the pandemic, I don't want to think about how difficult this would have been for me if I didn't.

For assistants and advocates the website does have a section listing alternate methods of obtaining help; including via TTY and normal phone lines; as well as email.

The CDC's website provides additional information which others might also recall from the announced launch of the website:

https://www.cdc.gov/vaccines/covid-19/reporting/vaccinefinde...

"Find a COVID-19 Vaccine: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you."

""" Get Help

Get answers to questions or help finding a vaccine near you. Help is available in English, Spanish, and many other languages. 1-800-232-0233 TTY 1-888-720-7489

Disability Information and Access Line (DIAL): 1-888-677-1199 DIAL@n4a.org """

A useful accessibility is not cheap. Every project has its budget. Most of website still can be read out by text-to-voice software which should be good enough for information delivery. There is definitely something can be improved later.

It is cheap though, and easy too. A basic form with standard HTML controls and appropriate labels is perfectly accessible with very little effort.

It takes effort to program custom dropdowns and other form elements and mangle a website into tag soup.

The budget to deal with the COVID pandemic is astronomical lol. The United States is literally throwing TRILLIONS at the pandemic. How many millions do you think adding these features would have cost?

Sure you can improve it later, but it's somewhat pathetic this wasn't working nearly two years after a pandemic was announced and it was almost a given we were going to need such a website?

The vaccines.gov website's Vaccine Finder requires javascript to run. It could have been served using HTML and a <form>.

Javascript isn't an accessibility issue. Modern screen readers work by interacting with a standard web browser, not by implementing their own browser engine. Javascript doesn't inherently interfere with this in any way.

The issue at hand is that these web sites lack accessibility information on some of their controls, making them difficult or impossible for a non-sighted user to interact with. This isn't a problem unique to Javascript; back in the day, one common cause of accessibility woes was the use of unlabelled imagemaps for navigation.

interesting, i didn't know that - thanks. My comment about the site requiring javascript stems from my thinking how needlessly complicated the entire site seemed in general, beyond accessibility.

Last year, I would try and open the Louisiana department of health website to look at covid statistics, and it would require about 70MB to load a small little box that displayed some numbers. The popular ArcGIS covid dashboard by Johns Hopkins was the same situation - a single page app that took tens of megabytes to load and was very slow - to the point where it would crash on my computer. It's made me think that specifically for issues of public health and public safety, a priority should be placed on making sure those websites load quickly and run smoothly.

Edit - I misspoke when I said it needed 70MB to load - it was 9+ MB of data transferred, 70+ MB resources. Here's a video I saved of the page loading from last year [0]

[0] http://telnet.asia/arcgisla.mp4

On the other hand, people complain about my "old-fashioned" web sites that are just html and css. But they load really fast :-)

It is possible, with great effort, to create JavaScript-driven UI elements that work correctly when used with accessibility technology. But if you stick to standard form elements, that support often comes by default.

For example, if the county dropdown box in the article had been a <select>, it would have automatically worked in the screen-reader without needing to write any additional code.

It's ridiculous that you're even being downvoted for what I think is a perfectly valid complaint, and one that I'm increasingly faced with these days. Scheduling appointments and such has been a solved problem for several decades; what are the chances that if this pandemic happened 20 years ago, sites for vaccinations would be usable with only basic HTML, and everyone, even the blind, can use?

Instead, today we get sites that need to load dozens of MB of JS that's reinventing the wheel (and forgetting to reinvent accessibility), are hard to use even for sighted people thanks to stupid UI trends like hidden scrollbars and whitespace everywhere, and fail completely if your browser is even slightly older or otherwise unusual.

There's really no reason for overcomplicating things other than web developers trying to justify their salary --- or Google attempting to make its effective browser monopoly even stronger. The continual churn of the web and the "doing less with more" direction that things are going is a horrible disease. This isn't progress; it's a regression.

A very related discussion from not long ago: https://news.ycombinator.com/item?id=25915313

I'm sure all of this will get fixed, it was obviously rushed like the vaccine, mask policy, lockdown, and everything else. In a couple of years they'll fix it, just like Healthcare.gov.

It wasn't rushed enough. A basic HTML form with appropriate labels is perfectly accessible and super easy to write.

It's custom controls and using JavaScript to make everything interactive that screws up accessibility, not just for blind users, but keyboard users too.

I hear this all the time and yet…nearly all of the websites failed.

This tells me that “you have to go out of your way…” doesn’t tell the whole story.

There’s clearly a disconnect between best-practice in-the-field UIs & framework; and what semantic web recommends.

Rather than attacking the government websites and businesses, pushing tooling to enforce good semantics would surely would be better?

Criticism isn't attack.

Nearly all had some issue. It doesn't mean they were completely unusable.

The disconnect is between common practice and good practice. Low contrast was 1 of the common problems. Usually this is a choice. And it's trivial to check.

It never fails to amaze me how seemingly impossible it is to get a web development firm to just write:

    <form>
      <label>Full name: <input type="text"></label>
      <label>Date of birth: <input type="date"></label>
      <label>Zip code: <input type="text"></label>
      <input type="submit" value="Submit">
    </form>

And then sprinkle a little CSS on top to make the colors match the client's theme.

It's really simple.

That's because web developers seem to have the notion that if it's not complex and hard, they have a hard time justifying their pay. So they make it complex, and when something like accessibility or browser support inevitably fails, they can charge more to "fix" it --- by of course adding even more complexity, and the cycle repeats.

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