An advisory committee at the Centers for Disease Control and Prevention (CDC) unanimously voted last week to recommend hepatitis A virus (HAV) vaccinations for all homeless people ages 1 and older to protect them against infection amid a multistate outbreak of the liver virus. The CDC is expected to approve the recommendation, CNN reports.

Since January 2017, 10 states have reported hepatitis A outbreaks, many of which have disproportionately affected homeless and drug-using populations. The virus is commonly spread through contaminated food and water and is more common among people without access to proper hygiene facilities, including showers and toilets. Hepatitis A can also be spread through sexual contact or through shared drug use via contaminated needles and other paraphernalia. 

Since the start of the multistate outbreak, the CDC has reported more than 6,000 hepatitis A infections, more than 3,800 hospitalizations and an estimated 70 deaths. The hepatitis A vaccine is currently recommended for travelers, men who have sex with men, drug users, people with clotting-factor disorders, those who work with nonhuman primates and people who anticipate close contact with adoptees from countries where hepatitis A is endemic. Healthy individuals between 1 and 40 years old who have been exposed to the virus are also encouraged to get the vaccine. The latest CDC recommendation would add homeless people to that list.

On a single night, more than 553,000 people experience homelessness in the United States, according to government reports. In a given year, about 3 million people—or 1 percent of the total American population—are classified as homeless. The CDC also reports that the number of homeless people is on the rise across the country and that the odds of infection with hepatitis A virus are two to three times greater for those who are homeless.

Currently, three licensed vaccines protect against hepatitis A. If approved, the CDC’s latest recommendation would allow these shots to be dispensed at clinics where homeless people receive health care and would be covered by Medicaid in some states.