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Accessibility and Usability of State Health Department COVID-19 Vaccine WebsitesA Qualitative Study

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The US Centers for Disease Control and Prevention allocates vaccines to individual states for distribution.1 Individuals seeking COVID-19 vaccine eligibility information and appointments must locate the resources provided in their state, making state department of health websites a primary source of information. Effective and equitable vaccine distribution depends, in part, on the accessibility and usability of these websites. Different levels of technology experience, reading abilities, and language preferences should not prevent individuals from obtaining needed vaccine information. Website usability should support determining vaccine eligibility, provide an indicator of when information was last updated, and provide web-based appointment scheduling and/or a wait-list and follow-up process. The vaccine rollout has resulted in frustration and inequities among underserved racial/ethnic groups.2,3 We analyzed each state’s department of health website for accessibility and usability challenges.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: April 26, 2021.

Published: May 26, 2021. doi:10.1001/jamanetworkopen.2021.14861

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Howe JL et al. JAMA Network Open.

Corresponding Author: Raj M. Ratwani, PhD, Medstar Health National Center for Human Factors in Healthcare, 3007 Tilden St, Ste 7M, NW, Washington, DC 20008 (raj.m.ratwani@medstar.net).

Author Contributions: Dr Ratwani had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Howe, Trafton, Ratwani.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Howe, Young, Trafton, Ratwani.

Critical revision of the manuscript for important intellectual content: Howe, Parau, Trafton, Ratwani.

Statistical analysis: Howe, Trafton, Ratwani.

Administrative, technical, or material support: Howe, Young, Trafton.

Supervision: Trafton, Ratwani.

Conflict of Interest Disclosures: Dr Trafton reported receiving grants from ONR during the conduct of the study. No other disclosures were reported.

References
1.
Centers for Disease Control and Prevention. COVID-19 vaccine distribution allocations by jurisdiction: Pfizer. Updated April 27, 2021. Accessed July 2, 2020. https://data.cdc.gov/Vaccinations/COVID-19-Vaccine-Distribution-Allocations-by-Juris/saz5-9hgg
2.
Ndugga  N , Pham  O , Hill  L , Artiga  S , Alam  R , Parker  N . Latest data on COVID-19 vaccinations: race/ethnicity. Kaiser Family Foundation. Published April 21, 2021. Accessed April 28, 2021. https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/
3.
Jean-Jacques  M , Bauchner  H .  Vaccine distribution—equity left behind?   JAMA. 2021;325(9):829-830. doi:10.1001/jama.2021.1205PubMedGoogle Scholar
4.
W3C Web Accessibility Initiative. Web content accessibility guidelines (WCAG) 2.1 Published June 5, 2018. Accessed April 24, 2021. https://www.w3.org/TR/WCAG21/#conformance
5.
Kincaid  J , Jr  RF , Rogers  R , Chissom  B . Derivation of new readability formulas (automated readability index, fog count and Flesch reading ease formula) for Navy enlisted personnel. Published February 1, 1975. Accessed February 11, 2021. https://apps.dtic.mil/sti/citations/ADA006655
6.
Jimenez  C , Lozada  P . Usability heuristics: a systematic review. Published 2016. Accessed February 11, 2021. https://ieeexplore.ieee.org/abstract/document/7750805/
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