I still don't see the issue with Vlad's reliable damage. Here's why.

Edit: Since many people aren't up to date on Red comments, Riot has stated that Vlad's sustain overall is not a problem, just the lane function of his Q. Riot wants to do a mini-rework to allow him to perform more reliably in todays meta, as well as add options of counter-play to his damage. That last part is what this is about.

Rioters themselves stated they thought his damage was too reliable in the mage post.

Otherwise, all they'd have to do is remove the flat heal on his Q and attach the ratio to W or his Ult rank. Add a decaying MS buff from his return particle on Q. Now he's up to date and ready to function against the majority of the cast. Alternatively, remove cast delays (which would make him a problem, imo).

Have you ever had a Vlad try to go and trade with you? You walk away and spam whatever spells you want at him. He takes damage, you don't.

The only time this isn't the case, generally, is for supports, who wouldn't want to get close to you even if you're melee, and other melee champions, which is the drawback of being melee.

If ADCs aren't a problem for the same reason while having higher DPS and often better poke, I fail to see how consistent damage makes a caster with similar range as ADCs a problem.

Yes his Q is a problem via the sustain it gives, and his consistent damage could be considered a problem, but it should be for ADCs as well if this is the case. If its not, you could make Vlad's Q draw minion aggro, make some mini-game out of the sustain, like every so many hits, something like Ahri, etc, and it would have the same functions that ADCs employ.

Any Vlad that's fought Orianna, Viktor, Azir, etc, knows that his consistent, reliable damage can't always save him. Instead of removing his strong suits, Riot should focus on his weaknesses and make those a more consistent factor. There are many options, one of which being less range, but making his Q return particle give a decaying MS buff. Another is changing his passive so there's more risk to being in that range.