Revelation 16:2: And the first went, and poured out his vial upon the earth; and there fell a noisome and grievous sore upon the men which had the mark of the beast, and upon them which worshipped his image.

The Third Woe of the seventh seal¹ officially begins in Revelation 16:2 when the first angel of seven² departs God's temple in heaven³ to pour out the first vial [bowl]⁴ upon the earth.⁵ In this context, the earth means dry land as opposed to the water and sky that will be afflicted by the three Vial Plagues that follow.⁶

John provides a three-fold description of the plagues associated with the first Vial Plague as noisome, grievous, and sore. The word noisome means evil or bad as an expression of extreme pain and danger.⁷ The word grievous means malignant and distressing.⁸ The word sore describes an ulcerous and deadly wound.⁹ These conditions will continue in combination with additional afflictions during the next three Vial Plagues.¹⁰ The sixth Egyptian plague caused boils that foreshadow the noisome and grievous sore of the first Vial Plague.¹¹

The first Vial Plague will afflict all people that have the mark of the beast and upon them which worshipped his image.¹² John describes this group of wicked people in Revelation 13:15-16.¹³ They include telestial-worthy people who survive the horrors of the Second Woe but refuse to repent.¹⁴ The Vial Plagues of the Third Woe do not target mortal sons of perdition because this class of people will die during the initial harvest of wicked people at the end of the Second Woe in Revelation 14:19-20.¹⁵

Once the Third Woe begins, the first Vial Plague will specifically target telestial people with death.¹⁶ The more righteous people will generally survive, including people that live terrestrial law and people worthy of the celestial kingdom but not exaltation.¹⁷ Exaltation-worthy people will not be subject to the horrors of the Third Woe because they will be standing with Christ on heavenly mount Zion after the harvest in Revelation 14:14-16. The selective destruction of the First Vial Plague mirrors the sixth Egyptian plague of boils that surgically fell upon the Egyptians while sparing the Israelites.¹⁸ However, the first Vial Plague will be much more severe than the sixth Egyptian plague.¹⁹ This first Vial Plague will also extend worldwide,²⁰ and shall also exceed in malignancy the first trumpet plague in Revelation 8:7 that afflicted only a third part of the earth.²¹