The smallpox vaccination that has been propagated in Styria by representatives of authorities, doctors and clergymen since 1802 did not only encounter approval. There was resistance from the beginning, which was expressed mainly by the rural population. It is hard to estimate the extent of this rejection, since the records about those who were “renitent against vaccination” are not conclusive and show too low figures. In fact, a double-digit percentage can be assumed. However, there were significant regional differences in Styria: while the vaccination coverage was relatively high in the Styrian capital of Graz and the southern parts of the region, the refusal was apparent especially in the area of Bruck and Judenburg. Women and mothers played an important role with regards to vaccination; they often took the decision whether children should be vaccinated or not. Did they decide against it, this did not happen for irrational and anti-progressive reasons only, as ascribed to them by the supporters of vaccination. The main argument for the refusal was health-related concerns. Such risks were real, even if their relevance was partly misjudged compared to the dangers of a smallpox disease. In order to put pressure on those who refused the vaccination, the so-called “Untertanenstrafpatent” of 1781 was applied in Styria over many years. On that basis, many prison sentences were inflicted on those “renitent against vaccination”.