Shot placement is everything. My only objection to recommending .22 lr for self defense is that rimfire ammo tends to misfire, and quality is inconsistent. What’s hot and “the best” one year is total crap the next.
Yes, shot placement is crucial. However potting paper at the range and shooting when you’re under fire are drastically different circumstances. There’s not a lot of people out there with ice water coursing through their bloodstream, and normal people in combat are not as accurate as they might like.
If shot placement were everything, wouldn’t SOCOM advocate using .22lr pistols? No, they understand that in actual combat conditions Murphy’s Law will prevail. Targets are not static in these conditions and you don’t have a lot of time to aim.
SOCOM pretty much has gone over to .45s these days. Army training has users of 9mms doing double taps as SOP.