What about the possibility that the user has an unknown or undetectable interferer? Otherwise the patch would not be offered. So, extrapolating from that idea maybe just installing a known interferer would be enough to prevent the patch being installed. E.g. the symptom looks like the install works but the apply phase does not.
C.f.
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To help prevent stop errors that are caused by incompatible antivirus applications, Microsoft is only offering the Windows security updates that were released on January 3, 2018, to devices that are running antivirus software that is from partners who have confirmed that their software is compatible with the January 2018 Windows operating system security update.
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