 The Gambia's routine childhood vaccination program is successful, but many vaccinations are delayed, with potential implications for disease outbreaks. A multi-dimensional approach was used to determine the timeliness of vaccination and data from 3,248 children in the Gambia 2019-2020 demographic and health survey were utilized. Nine tracer vaccines administered at birth and at two, three, four, and nine months of life were included. Routine coverage was high but also a high rate of untimely vaccination. Delayed vaccination was the most common dimension of untimely vaccination, with median delays ranging from 11 days to 28 days across all vaccines. The birth dose of Hepatitis B vaccine had the highest delay and was more common in the 24-35 months age group compared to the 12-23 months age group. Early vaccination was the least common, ranging from 4.9 percent to 10.7 percent for all vaccines. The Gambia's childhood immunization system requires urgent implementation of effective strategies to reduce untimely vaccination in order to optimize its quality, even though it already has impressive coverage rates. This article was authored by Ogambro Moriri, Chickasie Edson Yutasi, Iduaco Como, and others. We are article.tv, links in the description below.