Moderator Note:  Welcome Matthew.   I have integrated your query with a recent topic:  How accessible is Zoom with NVDA?
It would be worth reviewing what's been previously discussed in it.

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Hello. Does anyone here know how to navigate the Zoom interface with NVDA when in the meeting? I always seem to loose focus with NVDA and I can't navigate at time's with the tab key. In fact, other screen reader's I use are having the same issue. Could there be an addon for NVDA? I have the latest version of the screen reader. 

Thank you