As a situational mute that doesn't speak aloud in VRChat often, my favourite addition in the accessibility emojis is the green arrow that points in the direction that you're looking.
I think it'd be really valuable to also have an arrow that points in the opposite direction, towards the player to indicate "me," "look at me," "follow me," etc. as we currently don't have an emoji that represents that. It would also be great if it was a different colour to easily tell the two apart. (EDIT: I mocked up the arrow in the image as orange, but I think it should be purple to match the "thumbs down" emoji.)
I've also seen people use the "pointing away" arrow as an upvote when sending it upwards, so this could similarly act as a downvote. Having emojis work for multiple contexts like this is also really appreciated.
I imagine it would also replace the "shush" emoji as it seems out of place in the accessibility section. It could simply be moved to a different page. I attached a mockup of what this would look like, for fun