When the vaccine was initially introduced, it was on a limited basis, with pretty much the vague testing that you mention. It has become of much wider use now, and much more data has been accumulated.
With that said, it isn't nearly as affective as say, the parvo virus vaccine or distemper (other k9 vaccines), but in the event of a severe bite, it will likely save your dog. For any other bite, it'll just likely reduce the costs, as hospitalization is usually at least cut in half.
Ian
ps, on a side note, a vet here used to work in Virginia Tech College, and since antivenom was so costly, they never used it. Success was still pretty high with fluid therapy and symptomatic treatment. Then again, it's mostly copperhead bites down there.