The necessary approval, manufacture, distribution and administration of the vaccine will not come easy. Hookworm is endemic to rural, impoverished regions of the world; therefore, there is not a viable commercial market for a hookworm vaccine. Despite these socioeconomic barriers, collaborations between governments and vaccine manufacturers are being established. For instance, Brazil has promised an industrial scale-up of the vaccine and will sponsor phase 3 clinical trials. These significant challenges do strain the feasibility of a hookworm vaccine, but the public health benefits are worth the additional effort.