BACKGROUND/PURPOSE: COVID-19 vaccines are supplied at no-cost to residents as a measure to prevent comorbidities, fatalities, and the increased risk of community transmission, thus protecting public health systems. However, vaccine acceptance among cancer patients remained uncertain. This study aimed to elucidate the vaccination rates among oral cancer patients at a medical center in Taiwan. MATERIALS AND METHODS: We included Individuals who attended for routine follow-ups from January 2021 to December 2022, with a total of 1448 patients subjected to comprehensive analysis. Medical records were reviewed to identify factors influencing vaccine acceptance. RESULTS: Our findings indicate that 1,264 patients received vaccinations, while 184 remained unvaccinated. The vaccination rates among patients in advanced disease stages and those with neck lymph node metastasis (N+) were significantly lower (both P < 0.001). Furthermore, a notable lower vaccination rate was evident among patients receiving active treatment modalities (P < 0.01). Conversely, age, and comorbidities (evaluated using the New Charlson Comorbidity Index), didn't show a significant correlation with vaccination rates. The risk of death caused by oral cancer among vaccinated patients was significantly lower compared to non-vaccinated group (P < 0.001). Logistic regression showed the risk of COVID infection was significant lower in vaccinated group than non-vaccinated group (OR = 0.31, P = 0.034). CONCLUSION: The risk of COVID-19 infection in oral cancer patients was lower among vaccinated group, and the vaccination was not associated with more mortality. Identifying the characteristics of non-vaccinated individuals and understanding factors influencing vaccine hesitancy in oral cancer patients is vital for developing targeted strategies to improve vaccine uptake.