Of course fentanyl is the preferred opioid for a reason. Using other options could increase surgical risks. But that seems pretty insignificant for anyone with OUD given how likely they are to die from overdose vs. other causes.
Proposal, people with "opioid use disorders" are more than likely suffering in some way that needs evaluation and treatment. Many of them were probably on something and then cut off suddenly from the supply of that something, leading them to seek illicit sources instead and leaving them in the position of both unregulated treatment, and being unable to get proper regulated treatment because they are labeled either addicts by people who know about their illicit use, or "drug seeking" by people who don't that they ask for access to their drug of choice and almost all sources of proper health will refuse to treat them without them first continuing to insist they stop their use entirely. Cutting them off suddenly again by simply making their drug of choice stop working does nothing at all to address the underlying reason why they think or do need the drug and treatment in the first place. Given that our medical system often gives you a drug and then kicks you out the door to deal with it and its effects on your own, this "vaccine" seems more likely to exacerbate the larger drug problem, even if the specific "opioid" problem is solved. More likely rather than getting someone off their drug habit, this will simply drive users its forced on into seeking out other drugs to get the same results, possibly at higher and even more unsafe dosages.
Drug use is a symptom, and until our medical community wises up to that fact, the fight against any "drug use disorder" is going to continue to be a losing fight.