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At what point does it not work? What happens when you click Steam's PLAY button? Does it get to the splash screen for settings and detection? Or does it simply not reach that point?
if you did, remove it, and see if that helps.
Documents\My Games\Fallout4
should have files Fallout4.ini Fallout4Prefs.ini
check windows event viewer and also windows reliability history
might be a game crash event or system related problems
windows or whatever operating system you have, comes with default security settings. neither steam nor the game installer nor the game make any changes nor bypass whatever antivirus, security settings, folder permissions, running programs you have on your system. up to YOU to manage all that for this game and any other game/app you install.