ok here is a theory the vats in fallout 3 and 4 is a chem injector built into the pip boy 3000 and its models.
why I think this is simple when used it sharpens the mind allowing for quick reaction and slows down time (know of any chems in game that do similar things...)
so here is the concept..
The Vault-Tec Assisted Targeting System or vats is a speciallized chemical injector built into combat and vault versions of the pip boy 3000 and its proto types, this V.A.T.S utilizes chemicals in the air to pump in a quick enviromental based chemical coctail into the user, causing them to experiance increased muscle reaction time and a precived stop or slowdown in time.
Along with this the V.A.T.S system also scans targets allowing users to quickly assess the danager and target the locations they want do to the chems and this the system greatly improves combat function.
adiction if vats was a chem it is likely people would become addicted to using it which is a double edged sword these people would be great in combat picking off targets quickly but would likely tired extremely fast when not using vats they may become over reliant on the system to the point where they can't hit a glass of nuka cola from 10 feet with a minigun or mininuke. Though this is rarely a problem as VATS addicts can just pop fixer and be done with it, but what happens when the user doesn't know it is adictive?
yeah just a fan concept for how a game mechanic works. basic concept is this vats is a drug that uses AIR based chemicals to enhance the users for a short time, this combined with a scanner on the pipboy means a trained combat user can easily pick off targets with it.
With this comes the theory that not all pipboys have V.A.T.S systems as it my be a optional addon for the pipboy 3000 and might not have been equiped to all of them (hence why no NPC uses it against you).
No clue where I was going with this theory but hey posting it anyway, cause it is cool for thought. as for why it is in fallout 4 area cause it is fallout 4's vats show off that sparked this idea.