Data as of Oct 28, 2026.
ITOT vs VHT: Differences, Returns & Fees
Over the year to Oct 28, 2026, ITOT returned +13.4% to VHT's +25.0%; 10% of their weight is in the same names.
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Net assets: $97.1bn on Oct 27, 2026 for iShares Core S&P Total U.S. Stock Market ETF, and $19.1bn on Sep 30, 2026 for Vanguard Health Care ETF.
Pair scorecard
ITOT costs 0.06 points a year less; their one-year returns differ by 11.6 points; ITOT is 5.0 times larger.
| Measure | ITOT | VHT |
|---|---|---|
| Return | ||
| Total return, 1 year | +13.4% | +25.0% |
| Benchmark | ||
| What it tracks | S&P Total Market Index (TMI) | MSCI US Investable Market Index (IMI)/Health Care 25/50 |
| Cost and size | ||
| Expense ratio | 0.03% | 0.09% |
| Net assets, as of Sep 30, 2026 | $95.9bn | $19.1bn |
| Holdings | ||
| Holdings in common | 10% | |
| Top ten holdings, share of the fund | 33.9% | 51.8% |
Holdings in common uses holdings dated Sep 30, 2026 and Oct 27, 2026. Method
Risk and return
Feb 6, 2004 to Oct 23, 2026 · 1,185 weekly returnsITOT returned slightly more: +879.9% to +797.6%. VHT swung slightly less: 16.4% to 17.4%. VHT fell less at its worst: −38.1% to −54.7%.
Full scorecard
9 measures, with how each is measured Open ↓
| Measure | ITOT | VHT | Edge | How it is measured |
|---|---|---|---|---|
| Return | ||||
| Total return | +879.9% | +797.6% | ITOT (slight) | Price change plus distributions, reinvested. |
| Annualized | +10.5% | +10.1% | ITOT (slight) | Total return as a yearly rate. |
| Price return | +562.8% | +552.3% | Tie | Price change alone, distributions left out. |
| Risk | ||||
| Volatility | 17.4% | 16.4% | VHT (slight) | Spread of weekly returns, annualized. Lower is steadier. |
| Downside deviation | 12.2% | 11.6% | VHT (slight) | Like volatility, counting only weeks below the Treasury bill rate. |
| Max drawdown | −54.7% | −38.1% | VHT | Deepest fall from a high to the low after it. |
| Risk-adjusted | ||||
| Sharpe | 0.56 | 0.56 | Tie | Return above Treasury bills per unit of volatility. |
| Sortino | 0.80 | 0.79 | Tie | Return above Treasury bills per unit of downside deviation. |
| Calmar | 0.19 | 0.27 | VHT | Annualized return divided by the max drawdown. |
Computed by ETFIQ from Tiingo daily prices and ETFIQ's distribution records, 1,185 weekly returns. Cash rate: the 13-week Treasury bill.
What they share
By the books each fund has filed, ITOT and VHT hold 10% of their money in the same securities at the same weight. Holdings dated Sep 30, 2026 and Oct 27, 2026.
half
10% in common
Only in one fund ↓
Side by side
ITOT and VHT on the fields both publish, as of Oct 28, 2026. Source: ETFIQ.
ITOT and VHT do different jobs. What does each one do in a portfolio?
- What each follows. ITOT follows S&P Total Market Index (TMI) and VHT follows MSCI US Investable Market Index (IMI)/Health Care 25/50.
- Holdings in common. 10% of the weight is in the same securities (holdings dated Oct 27, 2026 and Sep 30, 2026).
- One-year total return. Over 1 year to Oct 28, 2026 ITOT returned +13.4% and VHT +25.0% with distributions reinvested, a gap of 11.6 points.
Data as of Oct 28, 2026.
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ITOT
ITOT tracks the S&P Total U.S. Stock Market. Over the year to Oct 28, 2026 it returned +13.4% with distributions reinvested. The prospectus expense ratio is 0.03% a year. By its holdings published by its issuer for Oct 27, 2026, 88% of the fund by weight is stocks the S&P 500 also holds, across 2,443 positions, with the top ten at 33.9%.
VHT
VHT tracks an index of Health Care. Over the year to Oct 28, 2026 it returned +25.0% with distributions reinvested, against +25.4% for its benchmark, the MSCI US Investable Market Index (IMI)/Health Care 25/50. The prospectus expense ratio is 0.09% a year. By its holdings published by its issuer as of Sep 30, 2026, 86% of the fund by weight is stocks the S&P 500 also holds, across 414 positions, with the top ten at 51.8%.
Questions people ask
- Which returned more over the last year, ITOT or VHT?
- In the year to Oct 28, 2026, with distributions reinvested, ITOT returned +13.4% and VHT +25.0%.
- Which is cheaper, ITOT or VHT?
- ITOT is cheaper, by 0.06 percentage points a year. That is about $6 on $10,000 held for a year. Fees come from each fund's prospectus.
Links are sources, not endorsements. A comparison is not a recommendation.
How this is computed
Overlap adds up the smaller of the two weights for each security both funds hold.
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ETFIQ, ITOT against VHT, data as of Oct 28, 2026. https://etfiq.com/compare/any/itot-vs-vht
ETFIQ. (Oct 28, 2026). ITOT against VHT. Retrieved from https://etfiq.com/compare/any/itot-vs-vht
[ITOT against VHT (ETFIQ, Oct 28, 2026)](https://etfiq.com/compare/any/itot-vs-vht)
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