[danShumway]

This is a bit misleading; you're losing accessibility only if you're never rendering to the actual DOM. A virtual DOM is just a way to avoid interacting with the real DOM until the last second, it doesn't really have anything to do with your final render target.

Svette avoids a virtual DOM while still rendering to the real DOM. It keeps itself fast by compiling your code to optimize unnecessary operations beforehand. Svette can still be used for accessible web apps.

JQuery and pure Javascript just manipulate the real DOM. This can come with performance consequences, but for many apps, the performance consequences don't matter. JQuery/Javascript can still be accessible.

React/Preact/etc... all use a virtual DOM. They can be accessible as well.

The virtual DOM is not the thing that gives you accessibility. You could have a virtual DOM that rendered to canvas and it would not meet accessibility standards. Accessibility is determined by your final render target, not by how you get there.