On October 23, 1768, Catherine the Great was administered a smallpox vaccine and became the first Russian monarch who motivated her subjects to get vaccinated with personal example. Catherine witnessed how her husband Perter III suffered the consequences of smallpox. As history shows, she was barely empathetic to him, rather Catherine was concerned that the pandemic in the palace would ruin her future plans. She studied available sources on smallpox vaccination and invited a British doctor Thomas Dimsdale to administer her a solution. The smallpox vaccine in the 18th century was a controlled injection of biomaterial of a sick person. Dr. Dimsdale selected a sick six years old peasant boy Sasha Markov as a donor and administered his lymph to the empress. Catherine experienced symptoms for a week and then got well and vaccinated her son Paul I. Sasha Markov became a nobleman with the last name Ospennyi (Smallpoxman).

Catherine's example set a fashion for vaccination that resulted in Senate's decree on celebration of smallpox vaccination day on November 21. The court immediately accepted the new fashion and Cathrine did not hide her satisfaction with this. She wrote to Voltaire: "A significant number of people followed the example, and many others are ready to vaccinate. In addition, the smallpox vaccination is now also administered at three orphanages and a hospital, built under the supervision of Dimsdale." In 1768 Catherine also wrote to her friend Belke: "The entire Petersburg wants to make a vaccine, and those who had already done it are healthy."

Today Russian authorities try to motivate vaccination with gifts, lotteries, and "good boxes." Such boxes contain useful medical gifts for pensioners, but still don't have significant impact on the vaccination rates.