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In this paper, elaboration of the image of smallpox in popular perception, which manifested itself in connection with the organization of smallpox vaccination by the Russian government, is examined. In the context of the cultural dominance of the ruling class over the people and paternalistic attitude towards it, promulgation of the vaccination is a unique phenomenon for the early 19th century Russia, when the “amount at stake” forced the authorities to appeal to their subjects. It provides an opportunity to analyze the symbols generated by the dominant ideology and their perception by traditional consciousness. Propaganda started by means of sermons by the clergy. Numerous Exhortations emphasized contraposition of the benefits of the vaccinated smallpox and the harm of the natural smallpox. The verbal channel of the agitation was supported by a visual one — publication of ”popular prints”. Analysis of the plots in nine images from D.A. Rovinsky’s collection showed that corporeality was recognized as the main means of the visual agitation. Through the image of human body, health and beauty of persons vaccinated against smallpox was transmitted, as well as deformity and hideousness of those who went through the natural smallpox. Having absorbed the dualism of the pro-government propaganda, popular consciousness went to create an alternative version of perceptions of the infection and vaccination. By applying the binary oppositions ’friend-foe’ and ’sacred-profane’, people made an important change in their own system of values: unlike other epidemics, such a particularly dangerous infection as smallpox had changed its place in the traditional worldview. It stopped being associated with plague and death and became recognized as being “one’s own” and ”godsent”. Therefore, it should not be opposed but should be accepted with gratitude as a ”gift of God”. Intercultural communications on the subject of smallpox vaccination are not only a vivid illustration of the ambiguous impact of the dominant ideology on a folk culture; the emergence of socially and culturally differentiated images of smallpox, having drawn a new demarcation line between the scholarly and folk cultures, deepened the rift in the Russian society, as well as introduced additional difficulties in the process of immunoprophylaxis and made it difficult to identify and treat the smallpox patients.