China’s response to global challenges, including efforts to achieve the United Nations Sustainable Development Goals, has been widely discussed. However, the dearth of official Chinese data on its global development activities has complicated empirical assessments. This article introduces a systematic way to measure China’s foreign aid through official customs records of exported aid goods. We illustrate the use of this approach by analyzing how Chinese aid allocation changed during the COVID-19 pandemic, with a particular focus on China’s mask and vaccine diplomacy. Our results show significant shifts in China’s aid after the outbreak of the COVID-19 pandemic. First, medical aid skyrocketed after the outbreak at the expense of non-medical aid. It was initially dominated by face masks and other protective equipment and later by vaccines. Second, China’s aid became global, extending beyond the Global South. Third, in the aftermath of the initial outbreak in March 2020, China’s aid became less strongly associated with both recipient needs and political friendship, which can be mainly attributed to the rise of aid through non-government sources. However, with the vaccine diplomacy period starting in 2021, we observe a renewed significant association of China’s aid with both economic needs and political alignment, resembling patterns from the pre-pandemic period.