I can see where it might make sense for certain people with very specific requirements to carry a .22. But each time I hear discussions like this, it makes .32 ACP, and even .25 ACP, begin to sound reasonable.
I realize both these calibers have fallen mostly out of use, and for good reasons, but hear me out.
.32 ACP provides significantly more power than a .22, and fits in a package not much bigger than a .22 pocket pistol. About 20 years ago, the Keltec P32 pistols were the new hot thing, and they really were light, tiny, and handy. In fact, they are so small and light, that they are not too comfortable to shoot, and may not be suitable for people with hand issues.
Which leads me to the mostly obsolescent .25 ACP. I realize this caliber has died, and when you do find rounds, they cost more than larger pistol rounds. But .25 was originally developed to run better in auto pistols than .22 rimfire. It is shorter, slightly fatter, and rimless, so it is really shaped to feed better. And it uses centerfire primers, which are much more reliable.
I think the cost of .25 ACP ammo would likely be a deal breaker, but when I hear people talk about carrying .22's, I often think that a modern plastic .25 ACP pocket gun might be worthwhile. I know that if I need a gun to work, I would really rather have centerfire primers.
I am also aware of studies which have shown that .22 LR is actually more effective than .25 ACP, but I'm not sure I believe it. They are very similar ballistically, and even if the studies were right, the difference is slight. My guess is that much more effort has been put into developing effective .22 LR rounds, and if anyone tried to make a decent .25 ACP, it would be very comparable.