This article is devoted to the historical analysis of the development of the legal basis of the preventive principle in healthcare in Russia from the moment of the emergence of official medicine (early 9th - 14th centuries) and until the early 90s associated with the transition from the state healthcare system (Beveridge - Semashko system) to the health insurance system (Bismarck system). The example of combating especially dangerous infections (smallpox, cholera, poliomyelitis, etc.) shows the humane approach of the Russian state to restrictive measures, the absence of strict coercive measures, the preservation of the principle of voluntariness and individual autonomy. It is proved that such principles are quite suitable in our time, in the context of the coronavirus pandemic, when proposals on the need for compulsory vaccination and stricter restrictive measures in relation to the population are actively discussed in some countries.