Death rates among black and Asian groups are higher than those in white people, which is “almost certainly” down to differences in vaccine take-up, a government adviser on Covid-19 and ethnicity said.
Deaths are lower than they were in the first and second waves after the introduction of the vaccination programme.
But disparities remain because of the gaps in vaccination rates, with experts calling on people to get their first, second and third shots as soon as possible.
Dr Raghib Ali, the UK government’s independent adviser on Covid-19 and ethnicity, said “nearly all” of the previous trends have reversed in the third wave.
Infection rates are now highest in white people, having risen between the second and third waves, in the least deprived and least densely populated areas that were previously less affected.
“This almost certainly reflects the overall immunity based on natural infection particularly, because London for example has the lowest vaccination rates but also the lowest infection rates at the moment, which really can be only due to differences in natural immunity," Dr Ali said.
“The problem, unfortunately, is that despite still having lower infection rates for South Asians and blacks in this third wave, their hospital rates and death rates are still higher than whites.
“And this almost certainly, sadly, reflects the difference in vaccination rates.”
Vaccination rates remain highest among white people and lowest in black groups, the report says.
It says that rates in older black African and Pakistani people had the biggest increase in the six months to October.
Dr Ali said there has been a “significant improvement” in vaccination among certain groups over the past months, but “the gap is still there”.
“Unfortunately, unless that changes it’s likely that the disproportionate risk for, particularly blacks but also South Asians, will still be there, even though in this third wave infection rates have decreased,” he said.
The final report into Covid-19 disparities, produced by the Cabinet Office’s race disparity unit and Dr Ali, outlines the main risk factors in ethnic minority groups.
These include: occupation, particularly for frontline workers; household size, particularly those containing schoolchildren and older relatives; and living in densely populated areas with higher levels of deprivation.
Factors for those infected such as being older, male, and having a disability or pre-existing health condition, were likely to increase the risk of dying.
The government said it used its findings to provide guidance and advice on how to reduce the risk of infection.
It issued guidance on preventing household transmission and measures to protect taxi drivers in the second wave as it emerged that the risk of dying with Covid was higher for Bangladeshi and Pakistani groups.
A higher percentage of people from these groups live in multigenerational households, while more than half of taxi drivers are from a minority ethnic background, the government said.
There have also been a host of initiatives to increase vaccine confidence and deal with misinformation by working with faith and community leaders, making vaccines available through pop-up clinics and places of worship, and holding information sessions.
Equalities Minister Kemi Badenoch said understanding of how different groups are affected by the virus has been “transformed” since the start of the outbreak.
“We know now that factors like the job someone does, where they live and how many people they live with impacts how susceptible they are to the virus and it’s imperative that those more at risk get their booster vaccine,” Ms Badenoch said.
A significant risk factor was living in multigenerational households in the second wave, when schools were open during lockdown periods, compared to the first wave when they were closed to most students.
Dr Ali said there is no “easy answer”, as keeping children home from school would damage their mental and physical health and education, adding that most grandparents would not want their grandchildren to suffer.
He said there was a need for better education for people in such households about ways they can best protect themselves.
Among the report’s recommendations is a warning for public health communications not to “stigmatise” ethnic minorities by singling them out and to improve the quality of health ethnicity data.
All recommendations in the report have been accepted by the government.