It's okay. The combat is pretty mediocre, and there's way too much of it. I was finding it way too easy early on but now I'm actually dying once in a while. There isn't any penalty for it though, so it's a lot more forgiving than, say, Dark Souls. I'm also 15 levels underleveled and get two-shot by every enemy because I haven't taken anyone's blood, so those extra juicy walking XP bags are looking pretty tempting right about now. Enemies give you 5 or 10XP per kill, and the average citizen will give you more like 2000. I was worried the "pacifist" route wouldn't actually be very punishing, but it is, if only because of the RPG-style damage scaling as you fall further and further behind. And not sucking their blood isn't even the objectively moral choice: most of the citizens are jerks and it's hinted the city would be much, much better off without them.
Many of the mechanics seem... poorly thought out, or poorly balanced. The illness system in particular is just pointless busywork; enemies drop so many materials you'll always have the ingredients you need, so it's just a matter of running around and healing everyone up whenever they get sick. There's no fast travel so it's actually kind of a hassle, and every time you rest to level up time progresses and more people get sick, which means more running through the same areas, hunting down the same people, and healing them. But I'm a doctor, dammit, and I won't take any lives. (Except for the infinite number of respawning enemies, because, well, video games).
VtM: Bloodlines it is not... but it does have dialogue trees and presumably, branching paths. And I've unlocked some interesting ways to resolve quests (that have sometimes backfired horribly). I had low expectations going in, and it's not knocking my socks off, but it's more or less competent. A solid 7/10, I'd say. Probably the closest thing to VtM that we've had since, well, VtM, so... if you're looking for a vampire RPG and can stomach some passable ARPG combat, it's not bad.