Not always. An inch or 2 off and you cut the the esophagus. If you don't damage the juglar vein, you get a deer running off without bleeding and you think you missed. Meanwhile the deer starves to death after suffering for a few weeks.

I've found dead deer with wounds in the neck as well as in the nose. My father even killed a buck with one eye shot out.

No reason not to target heart/lung area. Larger target, still deadly when a few inches off or deer makes sudden movement.