What does it do? I guess it's something about Work vs Home, but the way it is a continuously variable setting makes me wonder if there is more to it.

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The PREF parameter is OPTIONAL and is used to indicate that the
corresponding instance of a property is preferred by the vCard
author. Its value MUST be an integer between 1 and 100 that
quantifies the level of preference. Lower values correspond to a
higher level of preference, with 1 being most preferred.
When the parameter is absent, the default MUST be to interpret the
property instance as being least preferred.
Note that the value of this parameter is to be interpreted only in
relation to values assigned to other instances of the same property
in the same vCard. A given value, or the absence of a value, MUST
NOT be interpreted on its own.
This parameter MAY be applied to any property that allows multiple
instances.
ABNF:
pref-param = "PREF=" (1*2DIGIT / "100")
; An integer between 1 and 100.