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Only works on the PC. In FO4 you can alter the looks of any unique, and even non-unique if you want to change a character for a short while. I wanted to change the looks of an NPC.
Never played as a vampire. All of my playthroughs for the last 5 or so years have been old saves. The only changes I've seen is that some locations show up as undiscovered.
That includes saves as a werewolf, never joining Companions, as Dragonborn, and not.
On the other hand, changing race in game with racemenu resets all of your skills to newbie.
Perhaps there's a workaround for a vampire?
Anytime you change your character's name thee will be a new set of save, which is a good thing.