Washington ? A second health care worker has died of a heart attack after receiving the smallpox vaccine, and officials are investigating whether vaccinations are to blame for cardiac problems seen in 17 people who have been inoculated.

The vaccine has never been associated with heart trouble, but as a precaution, the Centers for Disease Control and Prevention is advising people with a history of heart disease not to be vaccinated until further investigation is complete.

CDC officials said Thursday there was some evidence the smallpox vaccine had played a role in heart inflammation. They were less certain whether three recent heart attacks were related to the vaccine.

In New York state, officials halted smallpox vaccinations altogether while the heart disease issue is sorted out.

Also Thursday, an expert panel advising CDC raised questions about the government’s vaccination program.

The Institute of Medicine suggested the CDC was moving too quickly beyond its first stage of vaccinations, which include public health and hospital workers, into a second stage, which includes a large group of emergency responders. The report, released Thursday, also called on the federal government to compensate people injured by the vaccine.

On Capitol Hill, lawmakers struggled to do just that, but a House vote scheduled for Thursday was abruptly canceled amid questions whether Republicans had enough votes to beat back a somewhat larger Democratic compensation plan.

The issue of smallpox vaccine safety gained new urgency this week after a Maryland nurse died Sunday of a heart attack, and the CDC launched an inquiry on a possible connection between heart disease and the vaccine.

The second death came Wednesday. Virginia Jorgensen, 57, of St. Petersburg, Fla., was a nurse’s aide at a local hospital. She suffered a heart attack about two weeks after being vaccinated against smallpox.

Like the other vaccine recipients with heart troubles, Jorgensen had a history of high blood pressure and other factors that put her at risk for heart attack.

“She’s been having heart problems for almost a year,” her husband, Robert Jorgensen, said Thursday. After the vaccination, he said, “within a few days she was feeling like she had a cold coming on and then it got bad.”

The recent deaths “display a sense of urgency” and make it plain legislation is needed, said Rep. Richard Burr, R-N.C., the chief sponsor of the Republican legislative package.

The latest GOP version would pay about $262,000 if a person dies or is permanently and totally disabled by the vaccine. Those less severely injured could receive up to $50,000 per year in lost wages, up to $262,000. They could also get unpaid medical expenses.

Democrats want more for lost wages and want funding for the program guaranteed.

CDC officials are investigating 17 heart problem cases, including seven civilians and 10 military people vaccinated.