This article discusses the development of the German-speaking anti-vaccination movement from the second half of the nineteenth century to the early twentieth century as an actor-centred history of knowledge. Although the German anti-vaccination movement was a heterogeneous milieu, recurring shared narratives can be identified within the argumentation of its actors: The movement is characterised by a high affinity to conspiracy theories and an anti-science attitude. Antisemitism and völkish ideologies are also a recurring element of this radical rejection of vaccination in the German-speaking region from the second half of the nineteenth century onwards. These narratives are used to construct a knowledge system of smallpox vaccination that was an alternative to medical science and the political decisions based on it.