Intestinal helminths infect approximately 2 billion people worldwide. Worm burdens correlate with disease morbidity and children generally harbor the largest numbers. The majority of intestinal helminths do not replicate within their host, and worm burdens increase through constant reinfection. Current strategies of worm control involve drug administration to school-aged children. Yet the rapid rate of reinfection and the appearance of drug resistant strains in livestock raise concerns over the sustainable nature of this strategy. A combined strategy of drug treatment for the expulsion of adult worms and vaccination designed to halt reinfection would offer the most effective means of control. Before successful vaccines can be developed our knowledge of the initiation and implementation of host immunity must be improved.