nih.gov: Accessibility — week 2026-W35

Automated Accessibility Conformance Report (OpenACR): Download ACR. Machine-readable; compatible with GSA OpenACR tooling. Automated tools find ~⅓ of real barriers — supplement with manual AT testing.

Training priorities

Top WCAG success criteria by pages affected this week. Use these to focus team training on the highest-impact issues.

SC	Criterion	Pages	Rules
1.4.1	Use of Color	28	2
1.4.6	WCAG 1.4.6	8	1
1.4.8	WCAG 1.4.8	8	1
2.5.5	WCAG 2.5.5	8	1
1.1.1	Non-text Content (images, icons)	2	2

Next 10 actions

Clusters are fingerprinted by normalized selector path + rule id + snippet shape. Rank score = (severity weight × pages affected) / distinct components for the rule. This supersedes the template threshold heuristic while still surfacing it as a validation signal.

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
All page content should be contained by landmarks · unattributed component Fix one place, resolve ~20 finding(s) on 20 page(s). XPath / selector: `.usa-alert` `<div class="usa-alert">`	Moderate	20	Requires manual testing.	Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.	pages (CSV)	Decision Assigned to Notes
All page content should be contained by landmarks · unattributed component Fix one place, resolve ~20 finding(s) on 20 page(s). XPath / selector: `#system-breadcrumb` `<h2 id="system-breadcrumb" class="visually-hidden">Breadcrumb</h2>`	Moderate	20	Requires manual testing.	Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.	pages (CSV)	Decision Assigned to Notes
Form field label is visible · unattributed component Fix one place, resolve ~8 finding(s) on 8 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	8	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Landmarks should have a unique role or role/label/title (i.e. accessible name) c · unattributed component Fix one place, resolve ~11 finding(s) on 11 page(s). XPath / selector: `#block-nih2-uswds-search` `<div class="search-block-form usa-form block block-search container-inline" data-drupal-selector="search-block-form" id="block-nih2-uswds-search" role="search">`	Moderate	11	Requires manual testing.	When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. "Primary" and "Footer" navigation) so screen-reader users can tell them apart.	pages (CSV)	Decision Assigned to Notes
aria attribute is permitted for element role · unattributed component Fix one place, resolve ~8 finding(s) on 8 page(s). XPath / selector: `@aria-label="Descripción de la agencia"`	Moderate	8	Requires manual testing.	Only use ARIA states/properties that are allowed on this element/role.	pages (CSV)	Decision Assigned to Notes
aria attribute is permitted for element role · unattributed component Fix one place, resolve ~8 finding(s) on 8 page(s). XPath / selector: `@aria-label="Official website of the Department of Health and Human Services"`	Moderate	8	Requires manual testing.	Only use ARIA states/properties that are allowed on this element/role.	pages (CSV)	Decision Assigned to Notes
Text has enhanced contrast · unattributed component Fix one place, resolve ~8 finding(s) on 8 page(s). XPath / selector: `text: "Get the Latest Updates and FAQs"`	Moderate	8	Requires manual testing.	Increase text contrast to meet WCAG AAA (7:1).	pages (CSV)	Decision Assigned to Notes
Text has enhanced contrast · unattributed component Fix one place, resolve ~8 finding(s) on 8 page(s). XPath / selector: `text: "Health Information"`	Moderate	8	Requires manual testing.	Increase text contrast to meet WCAG AAA (7:1).	pages (CSV)	Decision Assigned to Notes
Text has enhanced contrast · unattributed component Fix one place, resolve ~8 finding(s) on 8 page(s). XPath / selector: `text: "Grants & Funding"`	Moderate	8	Requires manual testing.	Increase text contrast to meet WCAG AAA (7:1).	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~8 finding(s) on 8 page(s). XPath / selector: `text: "NIH Websites Are Changing"`	Moderate	8	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes

Bug reports

3 issue type(s) are shown by default out of 18 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 1 critical, 2 serious, 14 moderate, 1 minor. By WCAG category: 6 WCAG 2.0 A, 3 WCAG 2.x AAA, 4 Best Practice, 5 Undetermined. Ordered by severity, key-page impact, WCAG level, and prevalence. Following accessibility bug-reporting best practices. Download: Markdown · JSON (full archive) · JSON (AI diagnostic) · CSV (all findings) · Priority pages CSV · Priority pages JSON.

Automated testing does not establish full WCAG conformance. Findings in the verification lane require manual testing before they are treated as confirmed failures.

Default view shows 3 prioritized issue type(s); 15 more are available if you switch to "Show everything".

2 finding(s) marked "possible duplicate" — Alfa and axe-core both flagged the same WCAG SC on overlapping pages. If they target the same element, the axe-core report is authoritative. Filter the CSV by possible_duplicate_of to see these. Two engines flagging the same barrier reduces the chance of a false positive.

Findings needing review

These findings need manual verification before they can be treated as confirmed failures. Obligation remains visible for each finding.

Serious axe link-in-text-block WCAG 2.0 A Links must be distinguishable without relying on color (WCAG 1.4.1) 20/3333 pages · 122 instances Likely template

Bug ID: VS-4efc24ce
Pattern ID: VS-8ade3360
Combined ID: VS-4efc24ce (pattern VS-8ade3360) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.4.1 Use of Color (Level A, WCAG 2.0)
Rule: axe-core — Links must be distinguishable without relying on color [link-in-text-block]
Example URL: https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions
XPath / selector: p:nth-child(10) > a[href$="niddk.nih.gov/"][data-extlink=""][rel="noopener nofollow noreferrer"]
History: first seen 2026-W25, last seen 2026-W35 (11 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a href="https://www.niddk.nih.gov/" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer" title="(opens in a new window)">https://www.niddk.nih.gov</a>

Description

Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 20 of 3333 scanned pages (122 instances).

Steps to reproduce

Open https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions.
Locate the element: p:nth-child(10) > a[href$="niddk.nih.gov/"][data-extlink=""][rel="noopener nofollow noreferrer"]
Confirm the axe-core finding for rule link-in-text-block against WCAG 1.4.1 Use of Color.

Impact

Affects Without color perception (4.5%), Limited vision (2.4%).

Without color perception — 4.5% of population
Limited vision — 2.4% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI

Triage status Notes

Critical axe image-alt WCAG 2.0 A Images must have alternative text (WCAG 1.1.1) 1/3333 pages · 2 instances Likely content

Bug ID: VS-2e6c599b
Pattern ID: VS-9074b4dd
Combined ID: VS-2e6c599b (pattern VS-9074b4dd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: axe-core — Images must have alternative text [image-alt]
Example URL: https://www.nih.gov/news-events/nih-research-matters/research-in-context
XPath / selector: .thumbnail-teaser:nth-child(3) > .thumbnail-teaser__link.link--no-tag[typeof="schema:WebPage"] > .thumbnail-teaser__img > .field--name-field-thumbnail.field--type-entity-reference.field__item > .image-style-thumbnail-large[loading="lazy"][width="200"]
History: first seen 2026-W29, last seen 2026-W35 (6 wk)

HTML snippet — use this to validate the finding without re-running the tool

<img loading="lazy" src="/sites/default/files/styles/thumbnail_large/public/2025-11/20251125-preg-.jpg?itok=5bGanDtb" width="200" height="auto" class="image-style-thumbnail-large">

Description

Images must have alternative text. Detected by axe-core rule image-alt on 1 of 3333 scanned pages (2 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/research-in-context.
Locate the element: .thumbnail-teaser:nth-child(3) > .thumbnail-teaser__link.link--no-tag[typeof="schema:WebPage"] > .thumbnail-teaser__img > .field--name-field-thumbnail.field--type-entity-reference.field__item > .image-style-thumbnail-large[loading="lazy"][width="200"]
Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/news-events/nih-research-matters/research-in-context

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.

Drupal tip: In Drupal's Media Library, fill the "Alternative text" field when uploading or editing an image. For images in body fields, the CKEditor "Image Properties" dialog includes an Alt Text field.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI

Triage status Notes

Serious axe list WCAG 2.0 A <ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1) 1/3333 pages · 1 instances Likely content

Bug ID: VS-e4065d4d
Pattern ID: VS-a0bdbdf6
Combined ID: VS-e4065d4d (pattern VS-a0bdbdf6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — <ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]
Example URL: https://nih.gov/news-events/nih-research-matters?page=84
XPath / selector: .usa-pagination__list
History: first seen 2026-W29, last seen 2026-W35 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<ul class="usa-pagination__list pager__items js-pager__items">

Description

<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 1 of 3333 scanned pages (1 instances).

Steps to reproduce

Open https://nih.gov/news-events/nih-research-matters?page=84.
Locate the element: .usa-pagination__list
Confirm the axe-core finding for rule list against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/news-events/nih-research-matters

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Use <ul>/<ol> with only <li> children for lists; don't fake lists with <div>s.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI

Triage status Notes

Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 20/3333 pages · 40 instances Likely template

Bug ID: VS-36393994
Pattern ID: VS-f18df681
Combined ID: VS-36393994 (pattern VS-f18df681) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — All page content should be contained by landmarks [region]
Example URL: https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions
XPath / selector: .usa-alert
History: first seen 2026-W25, last seen 2026-W35 (11 wk)

HTML snippet — use this to validate the finding without re-running the tool

<div class="usa-alert">

Description

All page content should be contained by landmarks. Detected by axe-core rule region on 20 of 3333 scanned pages (40 instances).

Steps to reproduce

Open https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions.
Locate the element: .usa-alert
Confirm the axe-core finding for rule region.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.

Drupal tip: Use Drupal's region system (header, navigation, main, sidebar, footer) and map each to an HTML5 landmark element in your theme's page.html.twig.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 14/3333 pages · 14 instances Likely template

Bug ID: VS-d0b1a01a
Pattern ID: VS-d25f622d
Combined ID: VS-d0b1a01a (pattern VS-d25f622d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Heading levels should only increase by one [heading-order]
Example URL: https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions
XPath / selector: article > div > h3
History: first seen 2026-W25, last seen 2026-W35 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h3>Reference</h3>

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 14 of 3333 scanned pages (14 instances).

Steps to reproduce

Open https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions.
Locate the element: article > div > h3
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.

Drupal tip: Drupal Views and blocks can insert headings at arbitrary levels. In the Views UI, set "Title tag" for each display. For block titles, configure the heading level in the block's layout settings.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI

Triage status Notes

Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 11/3333 pages · 12 instances Likely template

Bug ID: VS-070ba14d
Pattern ID: VS-8806389c
Combined ID: VS-070ba14d (pattern VS-8806389c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Landmarks should have a unique role or role/label/title (i.e. accessible name) c [landmark-unique]
Example URL: https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
XPath / selector: #block-nih2-uswds-search
History: first seen 2026-W29, last seen 2026-W35 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<div class="search-block-form usa-form block block-search container-inline" data-drupal-selector="search-block-form" id="block-nih2-uswds-search" role="search">

Description

Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 11 of 3333 scanned pages (12 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
Locate the element: #block-nih2-uswds-search
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. "Primary" and "Footer" navigation) so screen-reader users can tell them apart.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI

Triage status Notes

Moderate alfa sia-r66 WCAG 2.x AAA Text has enhanced contrast (WCAG 1.4.6) 8/3333 pages · 435 instances

Bug ID: VS-8d96b32d
Pattern ID: VS-646b1e0b
Combined ID: VS-8d96b32d (pattern VS-646b1e0b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.6 Contrast (Enhanced) (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has enhanced contrast [sia-r66]
Example URL: https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
XPath / selector: text: "Get the Latest Updates and FAQs"
History: first seen 2026-W25, last seen 2026-W35 (9 wk)

Description

Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 8 of 3333 scanned pages (435 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
Locate the element: text: "Get the Latest Updates and FAQs"
Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Increase text contrast to meet WCAG AAA (7:1).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66

Triage status Notes

Moderate alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 8/3333 pages · 228 instances

Bug ID: VS-898f502d
Pattern ID: VS-cb53cc4d
Combined ID: VS-898f502d (pattern VS-cb53cc4d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 2.5.5 Target Size (Enhanced) (Level AAA, WCAG 2.1)
Rule: Siteimprove Alfa — Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]
Example URL: https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
XPath / selector: <a class="usa-button" href="/web-modernization">
History: first seen 2026-W25, last seen 2026-W35 (9 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 8 of 3333 scanned pages (228 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
Locate the element: <a class="usa-button" href="/web-modernization">
Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 8/3333 pages · 32 instances

Bug ID: VS-172c3aec
Pattern ID: VS-c18be945
Combined ID: VS-172c3aec (pattern VS-c18be945) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Scrolling content can be accessed by keyboard [sia-r57]
Example URL: https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
XPath / selector: text: "NIH Websites Are Changing"
History: first seen 2026-W25, last seen 2026-W35 (9 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 8 of 3333 scanned pages (32 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
Locate the element: text: "NIH Websites Are Changing"
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57

Triage status Notes

Moderate alfa sia-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 8/3333 pages · 26 instances

Bug ID: VS-6312a8d9
Pattern ID: VS-2208081b
Combined ID: VS-6312a8d9 (pattern VS-2208081b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has minimum contrast ratio of 4.5:1 [sia-r73]
Example URL: https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
XPath / selector: <p class="usa-banner__header-text">
History: first seen 2026-W25, last seen 2026-W35 (9 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 8 of 3333 scanned pages (26 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
Locate the element: <p class="usa-banner__header-text">
Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73

Triage status Notes

Moderate alfa sia-r62 WCAG 2.0 A Link in text block is visually distinguishable without color (WCAG 1.4.1) 8/3333 pages · 22 instances

Bug ID: VS-24fdb8ec
Pattern ID: VS-efd91fdd
Combined ID: VS-24fdb8ec (pattern VS-efd91fdd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.4.1 Use of Color (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Link in text block is visually distinguishable without color [sia-r62]
Example URL: https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
XPath / selector: <a href="https://pubmed.ncbi.nlm.nih.gov/32640131/" class="ext" data-extlink="" target="_blank">
History: first seen 2026-W25, last seen 2026-W35 (9 wk)

Description

Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 8 of 3333 scanned pages (22 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
Locate the element: <a href="https://pubmed.ncbi.nlm.nih.gov/32640131/" class="ext" data-extlink="" target="_blank">
Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color.

Impact

Affects Without color perception (4.5%), Limited vision (2.4%).

Without color perception — 4.5% of population
Limited vision — 2.4% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Make links visually distinguishable from surrounding text (not by color alone).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62

Triage status Notes

Moderate alfa sia-r18 Undetermined aria attribute is permitted for element role (WCAG criterion undetermined) 8/3333 pages · 16 instances

Bug ID: VS-91030030
Pattern ID: VS-e05344b9
Combined ID: VS-91030030 (pattern VS-e05344b9) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — aria attribute is permitted for element role [sia-r18]
Example URL: https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
XPath / selector: @aria-label="Descripción de la agencia"
History: first seen 2026-W25, last seen 2026-W35 (9 wk)

Description

aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 8 of 3333 scanned pages (16 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
Locate the element: @aria-label="Descripción de la agencia"
Confirm the Siteimprove Alfa finding for rule sia-r18.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Only use ARIA states/properties that are allowed on this element/role.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18

Triage status Notes

Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 8/3333 pages · 8 instances

Bug ID: VS-e4e5537b
Pattern ID: VS-7118fead
Combined ID: VS-e4e5537b (pattern VS-7118fead) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field label is visible [sia-r61]
Example URL: https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W25, last seen 2026-W35 (9 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 8 of 3333 scanned pages (8 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61

Triage status Notes

Moderate alfa sia-r53 Undetermined Headings are structured hierarchically (WCAG criterion undetermined) 8/3333 pages · 8 instances

Bug ID: VS-91bc952b
Pattern ID: VS-f054f4a4
Combined ID: VS-91bc952b (pattern VS-f054f4a4) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Headings are structured hierarchically [sia-r53]
Example URL: https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
XPath / selector: <h3>
History: first seen 2026-W25, last seen 2026-W35 (8 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 8 of 3333 scanned pages (8 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
Locate the element: <h3>
Confirm the Siteimprove Alfa finding for rule sia-r53.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Use headings in a logical, non-skipping order.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 1/3333 pages · 2 instances · possible duplicate Likely content

Bug ID: VS-6cd33f8e
Pattern ID: VS-a24eaa8c
Combined ID: VS-6cd33f8e (pattern VS-a24eaa8c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Image has accessible name [sia-r2]
Example URL: https://www.nih.gov/news-events/nih-research-matters/research-in-context
XPath / selector: <img loading="lazy" src="/sites/default/files/styles/thumbnail_large/public/2025-11/20251125-preg-.jpg?itok=5bGanDtb" width="200" height="auto">
History: first seen 2026-W29, last seen 2026-W35 (5 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-2e6c599b (pattern VS-9074b4dd). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 1 of 3333 scanned pages (2 instances).

Steps to reproduce

Open https://www.nih.gov/news-events/nih-research-matters/research-in-context.
Locate the element: <img loading="lazy" src="/sites/default/files/styles/thumbnail_large/public/2025-11/20251125-preg-.jpg?itok=5bGanDtb" width="200" height="auto">
Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/news-events/nih-research-matters/research-in-context

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give every <img> an accessible name (alt text), or alt="" if purely decorative.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2

Triage status Notes

Moderate alfa sia-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 1/3333 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-30194558
Pattern ID: VS-3c632d31
Combined ID: VS-30194558 (pattern VS-3c632d31) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Element has required owned roles [sia-r64]
Example URL: https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
XPath / selector: <h3>
History: first seen 2026-W25, last seen 2026-W35 (7 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-e4065d4d (pattern VS-a0bdbdf6). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 1 of 3333 scanned pages (1 instances).

Steps to reproduce

Open https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems.
Locate the element: <h3>
Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64

Triage status Notes

Moderate alfa sia-r85 Undetermined Keyboard trap does not exist (WCAG criterion undetermined) 1/3333 pages · 1 instances Likely content

Bug ID: VS-a0f2b2ca
Pattern ID: VS-4c341c77
Combined ID: VS-a0f2b2ca (pattern VS-4c341c77) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Keyboard trap does not exist [sia-r85]
Example URL: https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
XPath / selector: <p class="nih-slogan">
History: first seen 2026-W29, last seen 2026-W35 (7 wk)

Description

Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 1 of 3333 scanned pages (1 instances).

Steps to reproduce

Open https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems.
Locate the element: <p class="nih-slogan">
Confirm the Siteimprove Alfa finding for rule sia-r85.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r85

Triage status Notes

Minor axe empty-heading Best Practice Headings should not be empty (WCAG criterion undetermined) 1/3333 pages · 1 instances Likely content

Bug ID: VS-a2074b15
Pattern ID: VS-0066c67d
Combined ID: VS-a2074b15 (pattern VS-0066c67d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Headings should not be empty [empty-heading]
Example URL: https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
XPath / selector: article > div > h3
History: first seen 2026-W25, last seen 2026-W35 (8 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h3></h3>

Description

Headings should not be empty. Detected by axe-core rule empty-heading on 1 of 3333 scanned pages (1 instances).

Steps to reproduce

Open https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems.
Locate the element: article > div > h3
Confirm the axe-core finding for rule empty-heading.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Remove empty headings or give them text. Don't use heading tags for spacing.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (7 rule type(s))

Each failing rule links out to the axe-core documentation. For full element-level detail including HTML snippets and XPaths, see the bug reports above.

axe-core rules failing in 2026-W35, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Links must be distinguishable without relying on color [link-in-text-block]	serious	20	122	/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions /news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection	all 20 pages (CSV)
All page content should be contained by landmarks [region]	moderate	20	40	/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions /news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection	all 20 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	14	14	/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions /news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection	all 14 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	11	12	/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection /news-events/nih-research-matters/research-in-context	all 11 pages (CSV)
Images must have alternative text [image-alt]	critical	1	2	/news-events/nih-research-matters/research-in-context	all 1 pages (CSV)
Headings should not be empty [empty-heading]	minor	1	1	/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems	all 1 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	1	1	/news-events/nih-research-matters	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (11 rule type(s))

Rule-level summary from Siteimprove Alfa (W3C ACT-based). Findings that overlap with axe-core on the same WCAG success criterion are noted as possible duplicates in the bug reports above.

Alfa rules failing in 2026-W35, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Text has enhanced contrast [sia-r66]	n/a	8	435	/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection /news-events/nih-research-matters/research-in-context	all 8 pages (CSV)
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	8	228	/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection /news-events/nih-research-matters/research-in-context	all 8 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	8	32	/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection /news-events/nih-research-matters/research-in-context	all 8 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	8	26	/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection /news-events/nih-research-matters/research-in-context	all 8 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	8	22	/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection /news-events/nih-research-matters/research-in-context	all 8 pages (CSV)
aria attribute is permitted for element role [sia-r18]	n/a	8	16	/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection /news-events/nih-research-matters/research-in-context	all 8 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	8	8	/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection /news-events/nih-research-matters/research-in-context	all 8 pages (CSV)
Form field label is visible [sia-r61]	n/a	8	8	/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care /news-events/nih-research-matters/preventing-organ-transplant-rejection /news-events/nih-research-matters/research-in-context	all 8 pages (CSV)
Image has accessible name [sia-r2]	n/a	1	2	/news-events/nih-research-matters/research-in-context	all 1 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	1	1	/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems	all 1 pages (CSV)
Element has required owned roles [sia-r64]	n/a	1	1	/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems	all 1 pages (CSV)

Unique accessibility issues (axe + Alfa consolidated)

axe and Alfa both implement W3C ACT rules, so the same issue is often caught by both. These are deduplicated by ACT rule and page, so a shared finding counts once (135 raw engine findings → 133 unique).

Unique issues (rule × page): 133
Caught by both engines: 2 highest confidence
axe only: 66
Alfa only: 65

2 rule type(s) caught by both engines — highest confidence

Two independent ACT-rule implementations (Deque axe-core and Siteimprove Alfa) flagged the same issue on the same pages. Agreement between separate engines is strong evidence the barrier is real, not a single-tool false positive — the best place to start.

Rules flagged by both axe-core and Alfa in 2026-W35, by pages affected.
Issue	Pages	Rule references
Images must have alternative text	1	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Headings should not be empty	1	axe empty-heading · Alfa sia-r64 · ACT ffd0e9