Regarding the BCG vaccine, it is advised that while anti-TNF levels are detectable, the vaccine should be postponed[23] due to the risk of developing disseminated tuberculosis.[24] It is important to mention that as vedolizumab has a high intestinal specificity, vaccinations can theoretically be safer than anti-TNF agents, which provide greater systemic immunosuppression; however, it is worth noting that the effectiveness of oral vaccines is likely to be reduced.[7,25]. This evidence concerns the gene TNF and miliary tuberculosis.