A government advisory committee on Wednesday recommended that all U.S. adults younger than 60 be vaccinated against hepatitis B, because progress against the liver-damaging disease has stalled.

The decision means that tens of millions of U.S. adults — mostly between the ages of 30 and 59 — would be advised to get shots. Hepatitis B vaccinations became standard for children in 1991, meaning most adults younger that 30 already are protected.

“We’re losing ground. We cannot eliminate hepatitis B in the U.S. without a new approach,” said Dr. Mark Weng of the Centers for Disease Control and Prevention.

The Advisory Committee on Immunization Practices voted unanimously to approve the recommendation Wednesday. The CDC’s director, Dr. Rochelle Walensky, must sign off on it before it becomes public policy, but it’s not clear when she will decide.

The virus is spread through contact with blood or other bodily fluids and many recent cases have been linked to the opioid epidemic.

An estimated 1.9 million Americans are living with hepatitis B infections, though many may not experience liver damage and accompanying symptoms for many years. The government has set a goal of eliminating viral hepatitis as a threat by 2030.

Officials previously recommended shots only for adults who fall into 15 categories of risk — a list that includes prisoners, health care workers, international travelers, patients with diabetes and certain other conditions, and people who inject drugs or who have multiple sexual partners.

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