Introduction/Background Higher risk of COVID 19 infection reported in patients with cancer. There are limited studies comparing the available vaccines in cancer patients.

Methodology Study was conducted to 370 patients with breast and gynecological cancer. Data collected on comorbidities, cancer diagnosis, stage and treatment, COVID 19 infection, severity, timing of infection to chemotherapy, COVID 19 vaccination status, and vaccine side effects.

Results By March 15th 2022, 40.3% of study population had received COVID 19 vaccine, 52.2% not yet & 7.6% were refusing it. Commonest vaccine received in chemotherapy group was Sinovac 56%, Pfizer & AstraZeneca 18.7% for each, while sputnik & Johnson 1.3%, 5.3% respectively.

Highest COVID 19 vaccine refusal was in elderly 71.4% P. < 0.01. Higher education patients were more likely to refuse vaccination P. < 0.03.

Gynecological malignancy cases were twice higher refusal rate to COVID vaccine compared to the breast cancer cases 13.5% vs 6.1% P. <0.01.

Multivariate analysis showed that CTH treatment increased risk of COVID 19 infection P. <0.001, Odds Ratio 4.6, 95% CI (2.3, 9.4).

Injection site pain reported by 66.7%, fever, flu like symptoms were reported in 20.8% 12.5% respectively. Vaccine side effects reported with AstraZeneca & Pfizer 41.7%, 37.5%, respectively, while 16.7% of cases received Sinovac reported any side effects P. < 0.001.

Gynecological cancer cases were at a higher risk to develop side effects post COVID 19 vaccination 29.2%, P. < 0.01 with odds ratio 3.54 and 95% CI (1.2, 10.1). 90% of reported severe COVID 19 infection were diagnosed with advanced malignancy P. <0.05.

Conclusion Higher vaccination refusal reported among elder patient with advanced stage gynecological cancers. Patients with cancer have increased risk to COVID 19 infection. There are no major safety concerns to receive COVID19 vaccination during CTH.