PDF files, commonly used across education (as well as other sectors) can be full accessible. Dedicated PDF creation tools such as Adobe Acrobat have all sorts of features to help make PDFs accessible, including an effective accessibility checker. Making scans of documents, book pages, and other articles in PDF accessible can be complicated, and necessarily must be discussed elswhere. Here, consistent with this guide's purpose, we will discuss professor-generated text in PDF format.
With that there are two major issues: ensuring the text is accessible to screen readers and other assistive technologies, and optimizing that by ensuring that heading styles carry into the PDF properly.
For Canisius faculty, the most efficient way to create PDF versions of your course content is to write that content in Microsoft Word, and then save it as a PDF. For a long time, saving as a PDF was minimally available by using the print utility. File --> Print --> Print as PDF (which acted as a printer driver.) While this will carry text into a PDF that is basically accessible, it will not carry Heading style tags into the PDF.
Instead, use dedicated Adobe Save As PDF tools available in Microsoft Word. (These are typically installed with Acrobat Pro, which is available to Canisius College faculty.) This ensures that both the text and specifically text tagged as headings is preserved within the PDF, and available for assistive technology such as screen readers and keyboard navigation tools.
In this video, you can see both how to properly save a Microsoft Word file as a PDF file, and how screen readers will handle the resulting PDF.
If you are scanning book pages, printed documents, or other paper matter to create readable digital files, you likely need to take extra steps before distributing the scanned PDF to students. Many scanner technologies will only record an image of the page; basically it's a picture. As noted in this guide, images of text are not accessible to screen readers and some other assistive tech.
Using Adobe Acrobat, you can create an OCR (Optical Character Recognition) data set within the PDF file, that assistive technologies are able to "see" and use. The success of this will vary to the degree that the scanner captured a good image, and that the text is legible. If you do a lot of scanning, you may need to familiarize yourself with Adobe's OCR toolset features, to optimize the quality of OCR Data.
Alternatively, you may wish to avoid scanning text from paper altogether, as it necessarily imposes some complications for developing accessible course content.
Adobe's documentation has the details: