You come out of the Vault with the following effects:
#1- Your face will be permanently reconfigured so it looks god-awful. Oh, and there'll be glitching so your character's body will spaz randomly.
#2- You will be forced to wear a simple white T-shirt with a frowny face and beige shorts and white sneakers.
#3- No stimpacks or any meds to help you.
#4- Enemies will kill you in three hits. From radroaches all the way to Deathclaws.
#5- Settlements will be hostile to you.
#6- Radiation kills you immediately.
#7- Your HP will be 10/10, your carry weight will be fixed to 50/100.
#8- Voice acting will be replaced with a high-pitched demonic-like wail.