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Impact of Obesity and Diabetes in Pregnant Women on Their Immunity and Vaccination.

Vaccines (Basel) · 2023 · PMC10385489 · PMID 37515062

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an increasing trendno p-value reported
Researchers noted an increasing trend in coverage with the tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine (49.8% in 2016 and 79.4% in 2018); however, the most significant variable associated with a lack of MV against pertussis was diabetes (39% less likelihood of vaccination).

also in 63,971 other papers

a decreasing trendno p-value reported
The coverage of vaccination against influenza followed a decreasing trend (11.9% in 2015 and 6.8% in 2018).

also in 47,180 other papers

Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.