I have been doing these 5 gal water changes pretty much from the beging , so I cannot tell you if water perams would be differant if I did not do them. I feel the water changes are good not only to remove old water , but the new water is adding minerals that are slowly being used. My water perams are perfect for me, all zeros, since adding the refugium my phosphates are zero too. I use no form fitering other then the rock and skimmer.
And no I do not need to vacume the sand at all, never did, and my sand is pure white, no dirt , no growth. I guess my clean up crew keeps it nice.