ASHINGTON, Feb. 27 — Officials are investigating medical problems in three health care workers who became ill after receiving the smallpox vaccine, though only one appears to have had a reaction to the inoculation.

The cases are the first reports of illness associated with the month-old civilian vaccination program, in which more than 7,350 people have been vaccinated. The three people, whom officials would not identify, live in Florida and are reported to be doing well.

One of the workers is a 39-year-old nurse who appears to have developed a rash called generalized vaccinia. Another, a 60-year-old man, already had symptoms of heart disease before being inoculated. He had chest pains four days later and was found to have a blocked coronary artery. The vaccine has never been associated with heart problems like angina.

The third health worker's gallbladder was removed because of acute inflammation. Gallbladder problems also are not associated with the vaccine.