Abstract Objectives To develop a framework to objectively measure the degree of fairness of any allocation rule aimed at distributing a limited stockpile of vaccines to contain the spread of influenza. Methods The trade-off between the efficiency and fairness of allocation strategies was demonstrated through an illustrative simulation study of an influenza epidemic in Southwestern Virginia. A Susceptible-Exposed-Infectious-Recovered model was used to represent the disease progression within the host. Results Our findings showed that among all the criteria considered here, the household size (largest first) combined with age (youngest first)-based strategy leads to the best outcome. At 80% fairness, highest efficiency can be achieved but in order to be 100% fair, disease prevalence will have to rise by approximately 1.5%. Conclusions This research provides a framework to objectively determine the degree of fairness of vaccine allocation strategies.