When Xiaomi received her measles, mumps and rubella (MMR) shot last month, her mother, Caroline Meng, a Beijing native, was relieved. The 20-month-old girl was originally scheduled to receive the shot two weeks earlier, but she had been coughing and sneezing the whole time, and doctors advised against vaccination until the little girl was perfectly healthy, since fever is a common reaction among children who receive the vaccine.
Predictably, Xiaomi was sick shortly after. Meng didn’t take it seriously. Then her phone beeped and she received a notification from Sina News. All she saw were the keywords in the headline: “Questionable Vaccines.” Caroline’s heart sank. She had long ago lost trust in China’s baby formula and toys, but vaccines too? Meng was anxious and fearful for a few days until she was told that the vaccines in question were not fake or contaminated, but had lost their potency. That merely left her angry.
“I thought everything has a bottom line,” said Meng, a university English lecturer. “Vaccines ARE the bottom line. So are children. There’s no hope for the future if that line is crossed.”
The vaccine scandal, as it has come to be known, involves the sale of $88 million worth of improperly stored vaccines since 2011, and has once again ignited public outrage over drug safety. It is only the latest in a series of healthcare scandals in China, including a government cover-up of the 2003 SARS crisis and the 2008 Sanlu milk powder scandal.
As trustworthy childcare products become a scarce resource, parents with and without money increasingly face very different options, and it’s not the difference between expensive toys or the public playground. Increasingly, it’s whether the bottom line can be secured. While those with the money and the means may place their trust in pricier foreign products, those without will have to make do with cheaper domestic offerings, often seen as less reliable.
Spending money on foreign childcare goods is nothing new for young parents who can afford to do so. Meng buys baby formula imported from Australia, often spending $15 on a can of 680 grams and another $15 on transportation. Fifteen weeks of milk powder supply costs $460, slightly less than half of the average monthly salary in Beijing.
“I don’t look at the price tag when I buy stuff for my baby,” said Zoe Zhang, another Beijing mom with a 2-year-old daughter. “I only look at the reputation and popularity of the brand among my friends.” Zhang buys water bottles and even chopsticks, one of China’s great inventions, from abroad. But she was still unsatisfied with the range of products available for overseas shopping and lamented the impracticality of buying foreign yogurt online.
“I definitely stay away from the cheapest brands,” said Chen Li, a 24-year-old mother with a one-year-old daughter in Jiexiu, a small county-level city of 300,000 people in Shanxi. “But I can’t afford any foreign products. Of course I would buy foreign brands if I could — there’s too much preservatives here.” Residents in megacities often have a vastly different lifestyle than those in smaller cities like Jiexiu, and geographical superiority is constantly flaunted in subtle forms. After the vaccine scandal first broke out, for example, some parents in Beijing comforted themselves that the city government must have tighter regulation and controls. After all, the leaders are all here.
Ironically, Chen Li was spared the worries that other young parents must have had in the initial days of the scandal — the local hospitals in her city didn’t even offer the “questionable vaccines.” According to Chen, it is normal for hospitals in cities the size of Jiexiu to only offer compulsory vaccines.
Unsurprisingly, Chen was incredulous when she read in the paper that some mainlanders were flocking to Hong Kong to get their kids vaccinated. For her, this seems like a first-world problem for people who have nothing better to worry about. But for those with the financial means, choosing imported vaccines is already the new normal. According to Zhang, the young mother from Beijing, parents can choose between an imported five-shot combo and a Chinese 13-shot combo to vaccinate against the same infectious diseases. The former came with a hefty price tag of $617, compared with $0 for the latter. Even before the vaccine scandal, everyone in her circle of friends was already choosing the five-shot combo. Fewer shots means less pain, but the more important consideration was quality.
Even before children are born, living in China carries its own price tag for women who are expecting. Infertility and spontaneous abortion are more common than ever. While the causes for both are myriad and hard to pin down, there is wide suspicion that bad air and food are the real culprits. According to Wang Yanbin, a gynecologist at Peking University People’s Hospital, expecting women have grown increasingly concerned about the risk of spontaneous abortions during the seven years she’s worked at the hospital.
For fear that unclean food would compromise the health of her unborn child, Meng stopped eating out the moment she learned about her pregnancy. Instead she opted for organic vegetables, which cost four times the price of regular ones sold in supermarkets. The upgraded diet, however, was only financially sustainable for the short period of her pregnancy. After the birth of Xiaomi, she chose to splurge more on her child than herself.
Things only get more complicated when the children are born. The different reactions to the vaccine scandal offer a glimpse into a tiny piece of the giant child-rearing puzzle in China. While the affluent were getting their kids vaccinated in Hong Kong or paying a substantial premium for imported vaccines, their less fortunate countrymen have to make do with made-in-China medicines. Other choices come with similar price tags.
Caroline Meng and her husband walked silently back home after visiting several kindergartens in their district to decide which one they should enroll Xiaomi in. They have a tough decision to make. The best and most expensive has a teacher to student ratio of 1:3.5, compared with 1:10 for the average kindergarten. Fewer teachers means less supervision and greater safety risk to the child, a risk Meng would never take.
In China, money buys trust — that is the case for vaccines, for milk powder, for vegetables, for kindergartens, and for a lot of other things. Adults are probably too jaded to even call it a life lesson. But luckily, Xiaomi is still too young to understand what all this means.
Qi Xie is a Visiting Student at Columbia Journalism School.
This article was originally published at The World Room on Medium.