Background: Vaccines protect immunosuppressed cancer patients from developing severe illness, hospitalization, and death. However, vaccination rates in cancer patients remain low, jeopardizing their long-term outcomes. Kaiser Permanente Northern California (KPNC) is one of eight health systems in the U.S. selected to participate in the Specialty Societies Advancing Adult Immunization Project awarded to ASCO and funded by the CDC and the Council of Medical Specialty Societies (CMSS). In conjunction with the ASCO Quality Training Program, we assessed the barriers to bivalent COVID-19 vaccination and applied quality improvement initiatives to increase the vaccination rate for adult cancer patients at KP Roseville. Our aim was to achieve a 50% bivalent COVID-19 vaccination rate by June 2023. Methods: Our population of interest included adult cancer patients receiving intravenous or oral chemotherapy. To assess the barriers to bivalent COVID-19 vaccinations, we distributed 100 surveys to oncology patients. We then performed two PDSA (Plan-Do-Study-Act) cycles for quality improvement and monitored the trends in bivalent COVID-19 vaccination rates from 3/20/2023 to 5/25/2023 with data extracted from electronic health records. Results: Surveys were returned from 63 of 100 oncology patients (35 unvaccinated, 28 vaccinated). Barriers to bivalent COVID-19 vaccination included lack of awareness (37%), fear of interaction with treatment (17%), inconvenience (14%), did not want it (14%), did not elaborate (14%), and prior reaction to the vaccine (3%). We conducted PDSA cycle 1 from 3/20/2023 to 4/14/2023. To improve awareness, we added bivalent COVID-19 vaccine content to the mandatory class for new cancer patients and distributed educational flyers at the oncology clinic. Only 1 out of 61 attendees during this period received vaccination following the class. PDSA cycle 2 was conducted from 5/1/2023 to 5/25/2023. We updated the educational flyer with the latest FDA/CDC recommendations. We also implemented a bi-weekly onsite vaccine station at the oncology clinic waiting area to improve convenience. By 5/25/2023, 78 of 320 eligible oncology patients received bivalent COVID-19 vaccines. As a result, bivalent COVID-19 vaccination rates at KP Roseville increased from 45% to 49% by June 2023. Conclusions: Despite the survey showing a lack of awareness as a major barrier to vaccination, increased awareness by itself had minimal impact on bivalent COVID-19 vaccination rates. However, the addition of a convenient onsite vaccine station in the oncology clinic along with providing education resulted in an increase in vaccinations. Our interventions led to promising results (49%) in the setting of generalized vaccine fatigue in the U.S. Our future goal is to expand these efforts to other KPNC oncology centers, establish stable onsite vaccine stations and include additional vaccine types.