Yeah, the main difference appears to be states that have high vaccine participation and states that don't.
Florida has the second-oldest population in the U.S., but it's death rate per 100,000 is average among the states. NYC and NJ are two states with the highest death rate per 100,000.
Both have very high hospitalization rates. Both also have very high vaccination rates.
In the worst case, it may just been that the vaccine effectiveness wanes over time.