I posted this over in the Spam-o-matic plugin thread on vbulletin.org, but never heard back.
It appears that this plugin leaves some keep-alive connections hanging, which goes unnoticed on small forums but can bring the admin site on larger forums to a screaching halt.
When I have the plugin enabled, any time I try to save anything on the admin site (not just within this mod, but anywhere) it will time out. As soon as I disable this mod, the problem goes away.
Here is what my host said about the issue. Again this seems to go away when I disable this mod..
Most likely, the code within the forum is allowing Keep-Alive connections, but it looks like they do not get closed efficiently and they stay open. This bogs down Apache, as it only has a certain number of connections allowed to be open at once. Have you had a developer take a look at the code and optimize the way it handles keep-alive connections? I would start there, and if there are any server-side configurations that the developer would need in order to optimize the site code, just open a ticket and we'll get it set to whatever they need.
It only seems to affect my largest forums, so I'm guessing that there is a bug in there leaving connections open and most forums just aren't large/active enough for the problems to be visible.