Spent a couple of hours and resolved my issue by a few steps. Perhaps a common troubleshooting section would be in order.

1. Uninstalled?most?plugins from VSCode.
2. Regererated project files in Unity
3. Told Unity in preferences to use "Code" as the Image Application
4. Switched to system mono in Code's preferences
5. Manually created launch.json with the button under the "Run" options.