 This way of characterizing harmful direct agency and harmful indirect agency could be thought of as two possible dimensions of agency in which harm is not intended, rather than as a contrast within a single dimension of agency. This view would be supported if it turns out that some complex plans of action count as both harmful direct agency and harmful indirect agency. For example, consider the deliberations of public health officials who propose to put in place a vaccination program in their region in order to protect citizens from a rapidly spreading, highly contagious, and invariably lethal disease. They foresee that if the program is carried out, about one in ten thousand vaccine recipients will experience adverse effects from the vaccine that will prove fatal, and the officials have no way to identify in advance which vaccine recipients will be susceptible to these adverse effects in order to screen them and exclude them from receiving the vaccine. It might seem that Double Effect is designed to explain why they may proceed with the vaccination program despite these foreseeable, regretted, and unpreventable unintended side effects of promoting a good end: this might seem to be a case of indirect agency. And yet, if the officials’ desire to bring about herd immunity leads them to advocate a widespread program with incentives for participation or even mandatory participation, then it will be true that harm comes to some victims that they have deliberately involved. This would make their actions in promoting the program a case of direct agency. Issues about consent may be relevant here as well: if the vaccine recipients willingly assume the risk of experiencing adverse effects, then a full description of the program must consider their own agency in assessing the information they receive. Examples like these suggest that the cases Double Effect has been taken to apply to may involve many different dimensions of agency rather than a sharp contrast that concerns a single dimension of agency.