Some of the changes are major, other just a variation of dialogue. There are some scene that are unlocked if you have certain level of corruption too.
"some of the changes are major" stab your caretaker on accident is something more than major-
makes sense, I got curious because it unlocks soome spiciness levels early. But as I don't like corruption (mostly the things that definitely will come with it) in mos histories. I'm keeping vanilla so far, but I got it on my radar now.
