This study is at the junction of two research areas, namely, the history of policies toward Tibetan Buddhist monks and the protective vaccination against smallpox in the Kalmyk steppe. The both policies were strongly associated with each other. After E. Jenner discovered a lower-risk cowpox vaccine in 1796, since 1802 the State Medical Collegium began the program of vaccination throughout the Russian Empire. However, the lack of health officials was serious in the newly obtained territories, so the local authorities commissioned religious elites vaccination. Buddhist monks vaccinated not only the Kalmyks, but also the Russians and the Tatars in Astrakhan. They were gradually limited to vaccination among the Kalmyks. Thirty years later, the Russian government, seeking to reduce the social influence of the monks, expelled them from the official vaccination. In the mid-19^<th> century the government claimed to train the novice monks as physician assistants. But after the mid-19^<th> century the lack of the official vaccinators was not improved. Actually, Buddhist monks actively worked in the unofficial vaccination efforts. Thus, in the dilemma between the promotion of vaccination and the plan to reduce social activities of Buddhist monks, the Russian government had no choice but to depend on the monks.