Hi Jeff. I've been using VSLilypond for VSCode for a while now and I found a solution for the annoying lack of refresh of the PDF output. It is here: https://github.com/lhl2617/VSLilyPond-PDF-preview/pull/118 Basically you have to edit a file of the Lilypond PDF preview extension (~/.vscode/extensions/lhl2617.lilypond-pdf-preview-0.2.8/out/extension/pdf-preview.js) and, look for "watcher.onDidChange" and add a similar construction for using "watcher.onDidCreate". And it works flawlessly. I think the owner of VSLilypond is not maintaining this project anymore. So this is not merged in the extension you can download and should be done by hand.
Regards, F.