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As the global shortage of Western vaccines persisted during the COVID-19 crisis, many severely affected countries become more susceptible to China's vaccine diplomacy, which involves trading vaccines for political concessions. The main focus of this article is to identify the factors that make China's vaccine diplomacy more effective. Using a mixed method, this study finds that political factors matter more than the severity of the health crisis. Countries are more likely to welcome China's vaccines if they enjoy higher geopolitical affinity with China, receive more Belt and Road Initiative investments, have no diplomatic ties with Taiwan, and are more authoritarian. No strong evidence can be found that the factor of crisis level is significant. This study also finds that China's donations of vaccines are less politically discriminatory than its sales. They can be used to bring countries closer into China's political orbit during the crisis.