Right Click fallot4.exe in install folder go to compatibility and check the "run as administrator" box. Do the same for fallot4launcher.exe then if you have steam started as administrator launch it normally otherwise launch fallout via the exe. I had these issues after I did this it works perfect. OBS might not work for everyone but it's worth a try.

Didn't work for me.

Well, I tried this again as a last resort and it finally worked as far as saving goes. Now when I rise out of the vault though my character is stuck on the vault platform and I can't move.

I'm glad saving is fixed. You might want to verify your game files via steam.
support dot steampowered dot com/kb_article.php?ref=2037-QEUH-3335&l=english

BUMP please help as many people as possible to see this thread as many issues is caused by this.