The Combat Medical Badge is retroactive to 6 December 1941. The original decoration was considered a one-time decoration, however this directive was rescinded in 1951 allowing for multiple awards of the Combat Medical Badge denoted by stars encircling the decoration. According to the US Army Medical Department Regiment, to date there have been only two soldiers that have earned the Combat Medical Badge with two stars: Henry Jenkins and Wayne Slagel. The directive was again altered in 1969 to specify that only one award of the Combat Medical Badge is authorized for service in "the Vietnam Conflict Era", which included service in Vietnam and Laos, the Dominican Republic, and South Korea (subsequent to 4 January 1969). Current regulations have expanded this qualifying period to include service in El Salvador, Grenada, Panama, Southwest Asia, and Somalia, and have added an additional qualifying period ("the Global War on Terror Era") covering service in Iraq and Afghanistan.