Health and medical care

Before you go: vaccinations

Book a travel health appointment 6–8 weeks before departure — vaccines need time to take effect, and some require multiple doses. Recommendations vary by individual health history and itinerary; the following are the standard starting point for most adults visiting China:

**Core (most travellers)**: - **Hepatitis A**: Transmitted via contaminated food and water. Two doses give lifelong protection. If you've never had Hep A and are eating street food or at local restaurants, get this. - **Hepatitis B**: Three-dose course (or accelerated two-dose course for rapid protection). Transmitted via blood and bodily fluids. Relevant if any medical treatment in China is possible, or longer stays. - **Tetanus / diphtheria / pertussis (Tdap)**: Booster if more than 10 years since last dose. - **Influenza**: Annual shot. Chinese flu strains circulate. Particularly relevant if travelling in winter or to crowded areas.

**Specific-risk vaccinations**: - **Typhoid**: Recommended if eating at local markets, street stalls, or anywhere outside international hotels. Typhoid vaccination is either a single injection or oral course of four capsules. Protects for 2–3 years. - **Japanese encephalitis**: Risk is real in rural parts of southern and southwestern China (Yunnan, Guangxi, Guizhou) in summer (June–October), especially near rice paddies. Recommended for travellers spending 30+ days in rural areas during mosquito season, or those camping or hiking extensively. - **Rabies (pre-exposure)**: Pre-exposure prophylaxis (three doses) is recommended if visiting remote areas, working with animals, or if post-bite medical access would be significantly delayed. Not a standard traveller recommendation but worth discussing with your travel doctor if your itinerary includes remote provinces. - **Cholera**: Low risk in most tourist areas; considered only for aid workers or those in very remote, sanitation-poor areas.

Yellow fever: Required certificate only if you are arriving from a country listed by WHO as having active yellow fever transmission. Not relevant if departing from Europe, North America, Australia, or most of Asia.

Travel insurance: what you actually need

Travel insurance for China should include, at minimum: - **Emergency medical treatment**: Aim for at least USD $100,000 coverage. International clinics in Beijing and Shanghai charge at Western rates: USD $200–500 per outpatient consultation, USD $2,000–5,000 per day inpatient at an international hospital. - **Medical evacuation**: Coverage of at least USD $500,000. Evacuation from a remote province (Qinghai, Xinjiang, rural Yunnan) to Beijing or Shanghai by medivac aircraft can cost USD $20,000–100,000. This is where inadequate insurance becomes catastrophic. - **Trip cancellation / interruption**: Valuable if booking expensive pre-paid tours (Tibet, Yangtze cruises).

Read the fine print: some insurers exclude China coverage for COVID-related claims, some require prior approval for non-emergency treatment, and some will not cover activities like motorbike riding or trekking above 4,000m without a specific adventure-sports add-on.

Healthcare quality and finding a doctor

Tier-1 city international clinics: These are your primary healthcare option as a foreigner. They have English-speaking doctors trained overseas or to international standards, electronic records systems, and clear billing.

Major operators: - **United Family Healthcare (和睦家)**: Hospitals in Beijing, Shanghai, Guangzhou, Shenzhen, Qingdao, Tianjin. The most comprehensive network for inpatient and specialist care. - **Parkway Health / Shenton Medical**: Clinics in Shanghai and Shenzhen. - **Beijing International SOS**: Occupational-focused but accessible. - **Raffles Medical**: Clinics in several tier-1 cities.

These clinics charge USD-equivalent rates and process international insurance directly for most major insurers. A standard GP appointment is USD $150–250; specialist consultations $300–500 [VERIFY: current consultation rates — May 2026].

Public hospitals (公立医院): Excellent for trauma and complex care (Chinese surgeons are among the world's most experienced in volume terms). Cost is a fraction of international clinics — outpatient consultation ¥200–500, procedures priced accordingly. The language barrier is the main challenge: English-speaking doctors are available at major teaching hospitals in Tier-1 cities (Peking Union Medical College Hospital, Ruijin Hospital in Shanghai), but are not available at most general wards. Have a Chinese-speaking contact or translation app ready.

In an emergency: Call 120 (ambulance) or go directly to the nearest Tier-3 Grade A (三级甲等) hospital emergency department. These are the highest-rated public hospitals. Major international clinic emergency rooms are also available.

Pharmacies

Pharmacies (药店, yàodiàn) are ubiquitous — every neighbourhood has multiple. Without prescription: - Paracetamol (对乙酰氨基酚), ibuprofen (布洛芬), aspirin - Antihistamines (loratadine/clarityn equivalent) - Antacids, proton pump inhibitors (omeprazole equivalent) - Loperamide (for diarrhoea) - Oral rehydration salts - Basic cold remedies

Chinese-brand equivalents are reliable and far cheaper than Western brands. Bring brand-specific medications you require; your specific antidepressant brand or specialised asthma inhaler may not have a direct Chinese equivalent available.

Tap water and food safety

Do NOT drink cold tap water. Boiled water from the hotel kettle is safe. Every hotel room in China — from hostel to five-star — has a kettle or thermos flask. See the dedicated tap-water guide.

At restaurants: food in established restaurants is generally safe. The main risks are: unwashed raw vegetables, ice at street stalls, shellfish at indoor-market stalls in summer. Traveller's diarrhoea is common in the first week for visitors from countries with different gut flora — self-limiting in 1–2 days usually, treatable with loperamide for symptom control and oral rehydration salts for fluid replacement.

Air quality

Highly variable by city and season. Track air quality daily using AQI apps (IQAir, AirVisual, AQICN.org). AQI above 150 warrants an N95/KN95 mask for extended outdoor activities; above 250, limit outdoor time. See the dedicated air-quality guide.

Altitude considerations

Relevant for: - **Lhasa (3,656m)**: Serious altitude; acetazolamide recommended from 24h before arrival. Rest on day one. Alcohol causes severe headaches at altitude — avoid for the first 48 hours. - **Everest Base Camp (5,200m)**: Acclimatise in Lhasa for 2 days minimum before heading up. - **Lijiang (2,400m)**: Moderate; some visitors notice headaches and reduced stamina. - **Xining (2,275m)**: Mild; most travellers adapt without medication. - **Shangri-La/Zhongdian (3,276m)**: Noticeable altitude; no prescription medication usually needed for healthy adults, but rest and hydration required.

Altitude sickness can affect anyone regardless of fitness. The 'walk high, sleep low' principle helps. If you develop confusion, extreme breathlessness at rest, or a headache that doesn't respond to ibuprofen/paracetamol, descend immediately — these are warning signs of acute mountain sickness progressing to oedema.

Common ailments and self-treatment