BB,
You (and nearly everyone else) needs to read my posts carefully. Phil, Dani and a few others (including bugsinabox?) already know this. I try to write my posts specifically to mean exactly what I write. I don’t always achieve that, but do try.
If it makes you think, all the better as that is a good attribute for a beekeeper to develop. Personally I only believe what is written - which is why I carefully analyse what politicians (for example) might spout, to understand that they generally don't actually answer the question posed.
Same applies to information offered on this forum, of course.
You will note that I never mentioned ‘certainty’. I prefer the term ‘probability’. Certainty is 100% definite on my probability scale. I just think nosema is now the most likely cause on my probability scale.
We don’t, I think (without checking) that the OP actually expanded on his meaning of ‘vaped’. It could mean it was carried out just once (where most mites could be within sealed brood cells) or it could mean the mite drop was low after three successive vapes at around 5 day intervals (to ensure all the mites in the hive were dosed at the phoretic stage of its life cycle).
You might understand that the former version could mean quite a high varroa load, shortly afterwards, if there was a lot of capped brood present at the time of a single vape.
Regarding the nosema comment, if nosema goes un-diagnosed and/or un-treated, oxalic acid has been implicated (by trickling only, as far as I know) in worsening colony survival over the winter period. It has been mentioned several times on this forum by at least one very experienced member. Nosema is not always a fatal disease, even if not treated, but really needs addressing to avoid future infections or rammifications.
Winter problems/losses due to nosema are clearly identifiable if the bees show signs of dysentery - either internally or externally on hive surfaces. Colonies might die without that sign and the ceranae version is mostly, if not always, the culprit in instances without obvious signs of dysentery.
Remember, as I have said many times, beekeeping is easy - especially if the beekeeper thinks carefully, before acting, and applies the KISS principle when the do.