Scholars who study governance in authoritarian countries have long highlighted the importance of fiscal capacity and pressure from the central government in determining the responsiveness and policy changes of subnational governments. However, policy orientation is also important in shaping how subnational governments react to a crisis. Using provincial governments’ responses during the 2018 Chinese vaccine scandal, I find strong evidence that an emphasis on public health, as well as early responses by neighboring provinces, increased the likelihood of a quick response.