Unless a refusal to permit record sharing is made under (e), health care providers and other agencies may disclose information specified in (c)(1) to (9) from the patient's medical record or the client's record to local health departments operating immunization information systems and to the State Department of Health Services. Local health departments and the State Department may disclose (c)(1) to (9) information to each other and to requesting health care providers taking care of a particular patient.
Limited by state and federal law and regulations limiting disclosure, local health departments and the State Department may share (c) information with any entity designated by federal or state law to receive such information. The State Department of Health Services may enter into written agreements to share confidential information with other states for the listed purposes and use of information must be limited to such purposes. Information may not be shared under this subdivision if the patient or patient's guardian refuses to allow the sharing of immunization information under (e) [i.e.