Yet in Fallout 4, during Vergil’s quest, you can find a cure serum for him that, in three days, makes him human again, with barely noticeable side-effects. A handwave if I ever saw one.
-- Vertibirds in Pre-War US.
Short and sweet, these things were not in use during Pre-War times. It wasn’t until the early 23rd century that the Enclave put them into use.
-- Pre-War Serenity.
If there’s any major change Bethesda made to Fallout that exposes how little respect they have for the lore of this series, it’s this. The Pre-War world was in no way serene as Fallout 4 would have you believe from the brief span of time you spend in it. So, time for a history lesson.
In the Fallout timeline, from April 2052 to October 23rd, 2077, the whole of the world was embroiled in what was known as the Resource Wars, conflicts waged over the drying up reserves of fossil fuels. Because the microprocessor was never invented in the Fallout timeline, the things we know today that depend on such technology, including computers, depended on fossil fuels, or in later years nuclear power, to function.
When the Middle East spiked prices on oil in 2052, the European Commonwealth declared war, marking the start of the Resource Wars. The resulting second rise in oil prices caused many smaller nations to go bankrupt, and two nuclear incidents, one in December 2052 from a terrorist attack, and another in early 2054 between several Middle Eastern countries, caused enough concern to get the US to start Project Safehouse. The project that would see the infamous Vaults created.
While the rest of the world was fighting over these resources, the US was experimenting with nuclear power, which took some of the resource strain off the nation. China meanwhile, being more dependent on fossil fuels than the US, invaded Alaska in 2066 as their sources of oil dried up; the US was becoming more successful with nuclear power at this time while holding onto oil reserves.
(According to Fallout: Tactics, this was how high gas prices went before the bombs dropped.
http://vignette1.wikia.nocookie.net..._Prices.png/revision/latest?cb=20090902133931)
For the last 11 years before the Great War, the US’s war against China would cause civil tensions to rise at home and in Canada, which had been pressured into allowing American soldiers to travel north through said nation. When Canada became annexed in 2076, the US responded to the resulting rioting and protests by executing those involved, which for those who remember the intro to the original Fallout was what we saw power-armored troops doing before waving to the camera.
Civil disorder and anti-government sentiment, already fueled through waning resources of food and energy, as well as war weariness from a decade of fighting with China, spiked in the wake of such atrocities and the US went under martial law.
Then came 2077, and October 23rd. While no one knows who fired the first missile, what we do know is long before the Great War happened, there were several drills and false alarms about incoming nukes aimed at all the populace, not just those who were chosen to be housed in Vaults. As such, when the actual event happened on the 23rd, millions died because they were convinced it was another false alarm.
In Fallout 4, we not only see the bombs dropping in the early morning on the East Coast, which contradicts bits of story in two of the New Vegas DLCs, Dead Money and Old World Blues, that the bombs fell during early evening on the West Coast, but Bethesda also skipped a two-fold opportunity to show some kind of role-playing chops in the intro they gave.
While I do not wish to give them ideas, lest they end up being taken like the mods they use from the Nexus and other places, I and likely others saw how the time between the morning character creation and the actual bombs falling could've been used to actually go to places around Boston and take part in certain events, things that flesh out the character you picked and let you see what’s going on with the rest of the world instead of the serene community you start in and never leave until it’s time to run to the Vault.