Aim <p>Breast cancer is the most prevalent cancer worldwide. When COVID-19 vaccines were first approved, clinical-trials specifically involving cancer patients were lacking and research on efficacy was not available. Thus, the purposes of this study were to investigate perceived safety and understanding toward COVID-19 vaccination amongst breast cancer patients and survivors, and explore the impact of the pandemic on cancer treatment and follow-ups.</p> Subject and methods <p>A web-based survey was sent to breast cancer patients or survivors in Saskatchewan, Canada between September and November 2021. Main questions on safety included participant perceived safety of the COVID-19 vaccine and vaccination status and for understanding it was how well informed they felt about the vaccine. For analysis, descriptive statistics, regression models and Spearman’s rank correlation coefficients were used (<i>p</i> &lt; 0.05).</p> Results <p>Among the 92 female participants, 96% had received the vaccine and 85% felt safe about it. Although most respondents felt adequately informed about the vaccine (&gt; 80%), 48% expressed concerns about vaccine. Higher income and recent diagnosis were associated with perceived safety (p = 0.004 and p = 0.003 respectively), and recent diagnosis was also associated with increased perceived understanding about the vaccine (p = 0.042). Additionally, disruptions in treatments (27%) and follow-up care (40%) due to the pandemic were reported.</p> Conclusion <p>Perceived safety and understanding of the COVID-19 vaccine were overall very positive among participants. However, strategies aimed at addressing concerns about vaccinations and reducing disruption of treatment and follow-up could be improved in future pandemics.</p>