I hit 60 Paladin on my alt about 5 weeks into Alexander normal progression. Since hitting level 60, I have never once equipped a single Vitality accessory on my Paladin for any content I have ever run, except for fun to see how high my health could go. I only ever went max VIT with a healer who couldn't keep me up with Shield Oath + CDs for busters through the first boss of Fractal.

This is. Fresh 60. I was in HQ/NQ whites. Full strength spec, full strength accessories. Successfully tanking the current expert dungeons without threat or death issues outside of one shit healer I had one time. I ran in Shield Oath on the bosses until I no longer had any left side white gear. Then I would pull in Shield and drop it before my second GB. Once I got about 50% blue, I started just doing Sword on bosses. I've also cleared all of Alex normal multiple times, MT and OT for every fight.

VIT is unnecessary outside of Savage.