There were 110 U.S. service members suffering from concussion-like injuries following the attack, but U.S. Central Command said a traumatic brain injury (TBI) diagnosis did not automatically qualify a service member to receive the award that is given to those wounded in combat.
"The first six Purple Hearts approved for injuries sustained during a Jan. 8, 2020 Iranian ballistic missile attack on Al Assad Air Base in Iraq were awarded to U.S. Army soldiers in Iraq and Kuwait on May 3 and 4, respectively," Cmdr. Zachary Harrell, a spokesman for U.S. Central Command, wrote in an email. "The awards were the first of 29 approved by Lt. Gen. Pat White, commander, Combined Joint Task Force- Operation Inherent Resolve, following a review in accordance with Army and Air Force regulations."
The remainder of the medals will be awarded later this week.
"It is important to note that a Traumatic Brain Injury (TBI) diagnosis does not automatically qualify a Service Member for Purple Heart eligibility or awarding," Harrell explained. "The CJTF-OIR process was designed to be a fair and impartial proceeding that evaluated each case in accordance with applicable regulations."
Initially the Pentagon said that there had been no injuries as a result of the January ballistic missile attack on the sprawling Iraqi base in western Iraq that housed up to 2,000 U.S. military personnel.
The blast waves from the missile strikes on the base resonated at some of the bunkers, particularly those that were close to impact areas, where U.S. forces had sheltered ahead of the attack. That ultimately led to some diagnoses of concussions that did not manifest themselves until a week later. In the weeks that followed up to 110 service members were diagnosed with concussion-like symptoms, which included headaches, dizziness, sensitivity to light, restlessness and nausea.
Those with serious symptoms were sent to U.S. military medical facilities in Germany and the United States for further treatment. The majority of the personnel eventually returned to their units in Iraq.
CJTF-OIR, the U.S. military command in Iraq, reviewed 80 recommendations for service members to receive the medal, but ultimately decided that only 29 met the criteria.
The U.S. Air Force concurred with the command's decision not to award the medal to two airmen who had been among those being considered.
As the first reports emerged that service members were experiencing TBI symptoms President Donald Trump seemed to minimize the injuries as "headaches" and as being "not very serious." His initial comments were controversial at the time since traumatic brain injuries are considered to be the signature wound of the American wars in Iraq and Afghanistan.
Defense Secretary Mark Esper later said that Trump was "very concerned" and "understands the nature of these injuries."
The Iranian missile attack was in retaliation for the U.S. missile strike in Baghdad that killed Gen. Qassem Soleimani, then-head of Iran's Islamic Revolutionary Guard Corps (IRGC).
While Iran has stepped back from any additional direct military action, it has continued to support Iraqi Shiite militias that have carried out subsequent attacks on U.S. military facilities in Iraq, prompting retaliatory U.S. military strikes.
On Monday, Esper told the Center for Strategic and International Studies that the U.S. sees continued Iranian support for those groups as a threat and "we have consolidated and hardened our positions" inside Iraq.