Doesn't ipv6 include efficiencies for this, like hierarchical prefixes?

In practical reality, doesn't that just mitigate the strain caused by an explosion in the size of the address tables?

A sometimes large but solvable part of the problem in ipv4 routing table sizes is numerically adjacent routes that could be aggregated into fewer announcements but aren't; ipv6 doesn't help with that. Another part of the problem is that many networks have lots of allocations that aren't adjacent, so they can't aggregate them; ipv6 should help with that as there's room for big allocations.

I guess it depends on how big the efficiency gain is, but afaik it's pretty big.