Chen Xiaonan is a busy mother. She has an art studio to look after during the day, and her 6-month-old son demands her attention at night. But despite her exhausting schedule, Chen is taking her son to be vaccinated -- at a clinic more than 1,000 km from her home.
"My son used to get injections at local clinics in Chongqing, but now we prefer doing it in Hong Kong," Chen said.
A growing number of Chinese parents like Chen are scrambling to make doctors' appointments in Hong Kong, in the hope that the former British colony, whose health care system differs from mainland China's, will offer their children better protection against disease. In online discussion groups, people are talking about traveling to Seoul, Tokyo or Singapore for vaccinations.
Although it is not uncommon to see mainland Chinese traveling abroad for higher quality medical care, the flow of patients has become a flood following a vaccine scandal that Chinese President Xi Jinping has described as "appalling."
On July 15, Changchun Changsheng Biotechnology, the country's second-largest maker of rabies vaccines, was found to have forged reports and violated regulations while producing 250,000 doses of rabies vaccines for humans. The vaccine prevents infection with the life-threatening virus in those bitten by rabid dogs. China has the second-highest number of reported rabies cases in the world, according to the World Health Organization.
While there have been no reports of deaths or illnesses related to the substandard vaccines, the news has shattered many Chinese parents' faith in a domestic consumer supply chain riddled with safety problems. In 2008, contaminated milk was discovered in several food products in China, including baby formula, killing four children and sickening tens of thousands. In 2016, an estimated $88 million of vaccines was reported to have been improperly refrigerated as vaccine distributors cut corners.
"How can we not be worried?" said Shuai Lili, a woman in Beijing. "I don't believe this is a single case. There must have been more." To protect her 2-year-old daughter, Shuai said she would either purchase imported vaccines or travel to Hong Kong for injections if certain imported vaccines are unavailable in the mainland Chinese market.
Although a trip to Hong Kong would cost her at least 10,000 yuan ($1,468), "It is worth it," Shuai said. "Everyone around me -- as long as they can afford it -- has decided to go to Hong Kong."
Five out of nine Hong Kong clinics contacted by the Nikkei Asian Review confirmed that inquiries from mainland Chinese parents have rocketed in the past two weeks. In Jordan, a Hong Kong neighborhood with hundreds of clinics packed into office buildings, a random elevator ride can bring one face to face with Chinese medical tourists.
One Beijing woman, who declined to give her name, said that she took her son to Hong Kong for hepatitis A vaccinations, due to concerns over the quality of domestic vaccines.
"Many Chinese have been doing the same," she said. The surge in demand put her son on a waiting list for more than a week. "But this is still considered fast," the woman said. "The clinic has now asked parents to make an appointment three months ahead."
With more Chinese mothers accompanying their children to Hong Kong, the city's gynecologists are also seeing more patients. The woman from Beijing, for one, took the opportunity to get a vaccine for human papillomavirus (HPV). At the clinic she visited, "Half the customers are mainland Chinese," the woman said.
HPV vaccines, also known as cervical cancer vaccines, have been a big draw for Chinese medical tourists. Few mainland clinics offer the shots, so around 2 million Chinese women a year come to Hong Kong for it, according to state-owned China National Radio.
Demand for the vaccine, which can prevent a potentially deadly form of cancer, is leading Chinese women to seek it in other parts of Asia. With vaccine supplies drying up in Hong Kong, a recent discussion on how to obtain HPV injections in Singapore attracted more than 26,000 views on Zhihu, a Chinese question-and-answer website similar to Quora. South Korea and Malaysia are also popular destinations for mainland Chinese seeking HPV vaccines.
According to Tianfeng Securities, China's medical tourism market reached $56.5 billion in 2015, up from $13.9 billion in 2010. Much of that growth was driven by outbound medical tourists, the report said.
But the explosion in Chinese medical tourists has caused bottlenecks in local markets. The Family Planning Association of Hong Kong, a leading nongovernmental organization promoting women's health, has restricted HPV vaccinations to local residents since April, citing a shortage of vaccines. The price for the vaccine has doubled in the past two years, making it hard for many women to complete the full course of three inoculations at most clinics. In June, about 20 angry mainland Chinese women turned up outside the Hong Kong office of Merck, a leading HPV vaccine maker, to protest the shortage.
For now, Hong Kong is not limiting vaccinations of mainland Chinese children. Although she finds the difficulty of getting an appointment with a Hong Kong doctor frustrating, Chen, the woman from Chongqing, has not given up. "If we use vaccination services in China, we would be counting on our luck," she said.