In the properties, go to the Compatibility tab and enable option Run this program in compatibility mode for 58 and disabling Vsync, but that actually made it worse, I fired up fallout, the video screen appeared (Vault cog/music), then it did the same thing again before the main menu came up. Follow the steps to update graphics card driver: If your machine meets min spec, check that you have the latest video card drivers.
But don’t worry as we’ve got you covered with 5 Ways to Fix Fix Fallout 4 Crashing on Startup.