Six people in Charlottesville yesterday became the first local health care workers in the region to be inoculated with the smallpox vaccine under a program to ready frontline medical staff for a possible biological attack.

The vaccine was given to five employees of health departments in Charlottesville and surrounding areas and one employee of the hospital at the University of Virginia. Their names were not disclosed, but the public health care workers were described as a doctor, three nurses and an environmental health specialist.

Susan McLeod, director of Charlottesville's Health Department, said the public health nurses who volunteered for the vaccine had arranged for some family members not to be present in their homes for a while, diminishing the risk of inadvertently transmitting the disease.

The health care workers who were inoculated are to administer the vaccine to other medical personnel beginning late this month, said Trina Lee, a Health Department spokeswoman. Virginia has received 10,000 doses of smallpox vaccine as a defense against an act of bioterrorism.

"Providing the smallpox vaccine to health care responders is an important element of our overall emergency preparedness efforts," said Virginia Health Commissioner Robert B. Stroube.

Neither Maryland, which last week received 6,000 doses, nor the District, which yesterday received its allotment of 5,000 doses, has started the mass inoculations. President Bush has called for as many as 11 million Americans to be inoculated by late summer. Officials in Maryland said the inoculations will not begin for two weeks. The D.C. Department of Health will begin administering its vaccines March 3.

Workers at military hospitals and other federal facilities have begun vaccinations.

Although inoculations will be given to health care providers, law enforcement personnel and other people who would probably be among the first to respond to a biological attack, the vaccine is not recommended for the general public.

Opposition to mass vaccinations has arisen at some hospitals and medical centers across the country. Because of the risk of dangerous side effects and passing on the disease to their patients, some health care providers have decided not to take the vaccine. Balanced against the risk of the vaccine itself is a frightening statistic: About 30 percent of those who get the most common form of the disease may die.

At Virginia Commonwealth University in Richmond, officials said the prominent teaching hospital has declined to inoculate its staff unless a case of smallpox is confirmed. In Maryland and the District, every hospital has agreed to have its staff inoculated.

Most hospitals have been preparing lists of positions they need to fill to remain open round-the-clock in the event of a smallpox outbreak. The jobs run the gamut, from doctors and nurses to admissions officers and housekeeping staff.

In Charlottesville, the University of Virginia Health System and Martha Jefferson Hospital anticipate inoculating about 130 people each to keep treating patients.

In addition, Virginia is preparing to inoculate 41 teams of up to 15 people each who probably would respond to an outbreak. The teams will include investigators who determine the level of exposure and health care workers able to provide vaccinations.

The doses of vaccine that were provided to states by the U.S. Centers for Disease Control and Prevention are being shipped to state health departments. Citing security reasons, state officials declined to say how they were being transported.

The CDC projects that as many as 42 of every 1 million people inoculated against smallpox will suffer severe side effects, such as blindness or inflammation of the brain. One or two will probably die.

More than three decades have passed since the last natural case of smallpox was reported in the world, in Somalia in 1977. The last case in the United States was confirmed in 1949. Routine smallpox vaccinations in the United States stopped in 1972.

Because so much time has passed since the disease was eradicated, the Maryland Department of Health and Mental Hygiene has trained about 300 health professionals on how to administer the vaccine.

"A lot of people didn't know how to give the vaccines," said J.B. Hanson, a spokesman for the agency. "It hasn't been done in a third of a century."

McLeod said the inoculated employees would not be made available for interviews. "We're looking at it as a private medical appointment," she said.

Once the doses of vaccine arrived, there was no reason to delay the initial inoculations, McLeod said.

"We'd been planning it for a while," she said. "The state told us that once we got the vaccine, we could go ahead and start."