Data as of Oct 28, 2026.
VHT vs XLV: Differences, Returns & Fees
Over the year to Oct 28, 2026, VHT returned +25.0% to XLV's +25.6%; 85% of their weight is in the same names.
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Net assets: $19.1bn on Sep 30, 2026 for Vanguard Health Care ETF, and $47.0bn on Oct 27, 2026 for State Street Health Care Select Sector SPDR ETF.
Pair scorecard
XLV costs 0.01 points a year less; their one-year returns differ by 0.6 points; XLV is 2.3 times larger.
| Measure | VHT | XLV |
|---|---|---|
| Return | ||
| Total return, 1 year | +25.0% | +25.6% |
| Benchmark | ||
| What it tracks | MSCI US Investable Market Index (IMI)/Health Care 25/50 | Health Care Select Sector Index |
| Cost and size | ||
| Expense ratio | 0.09% | 0.08% |
| Net assets, as of Sep 30, 2026 | $19.1bn | $43.4bn |
| Holdings | ||
| Holdings in common | 85% | |
| Top ten holdings, share of the fund | 51.8% | 60.6% |
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 returnsVHT returned slightly more: +797.6% to +724.9%. XLV swung slightly less: 16.1% to 16.4%. VHT and XLV fell about the same at their worst: −38.1% and −37.9%.
Full scorecard
9 measures, with how each is measured Open ↓
| Measure | VHT | XLV | Edge | How it is measured |
|---|---|---|---|---|
| Return | ||||
| Total return | +797.6% | +724.9% | VHT (slight) | Price change plus distributions, reinvested. |
| Annualized | +10.1% | +9.7% | VHT (slight) | Total return as a yearly rate. |
| Price return | +552.3% | +464.5% | VHT | Price change alone, distributions left out. |
| Risk | ||||
| Volatility | 16.4% | 16.1% | XLV (slight) | Spread of weekly returns, annualized. Lower is steadier. |
| Downside deviation | 11.6% | 11.3% | XLV (slight) | Like volatility, counting only weeks below the Treasury bill rate. |
| Max drawdown | −38.1% | −37.9% | Tie | Deepest fall from a high to the low after it. |
| Risk-adjusted | ||||
| Sharpe | 0.56 | 0.55 | VHT (slight) | Return above Treasury bills per unit of volatility. |
| Sortino | 0.79 | 0.77 | VHT (slight) | Return above Treasury bills per unit of downside deviation. |
| Calmar | 0.27 | 0.26 | VHT (slight) | 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, VHT and XLV hold 85% of their money in the same securities at the same weight. Holdings dated Sep 30, 2026 and Oct 27, 2026.
half
85% in common
Only in one fund ↓
Side by side
VHT and XLV on the fields both publish, as of Oct 28, 2026. Source: ETFIQ.
VHT and XLV are built for the same job. How do they differ in cost, holdings and results?
- What each follows. VHT follows MSCI US Investable Market Index (IMI)/Health Care 25/50 and XLV follows Health Care Select Sector Index.
- Number of holdings. VHT holds 414 positions and XLV holds 62.
- Holdings in common (similar). 85% of the weight is in the same securities (holdings dated Sep 30, 2026 and Oct 27, 2026).
Data as of Oct 28, 2026.
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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%.
XLV
XLV tracks an index of Health care. Over the year to Oct 28, 2026 it returned +25.6% with distributions reinvested. The prospectus expense ratio is 0.08% a year. By its holdings published by its issuer for Oct 27, 2026, 100% of the fund by weight is stocks the S&P 500 also holds, across 62 positions, with the top ten at 60.6%.
Questions people ask
- Which returned more over the last year, VHT or XLV?
- In the year to Oct 28, 2026, with distributions reinvested, VHT returned +25.0% and XLV +25.6%.
- Which is cheaper, VHT or XLV?
- XLV is cheaper, by 0.01 percentage points a year. That is about $1 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, VHT against XLV, data as of Oct 28, 2026. https://etfiq.com/compare/any/vht-vs-xlv
ETFIQ. (Oct 28, 2026). VHT against XLV. Retrieved from https://etfiq.com/compare/any/vht-vs-xlv
[VHT against XLV (ETFIQ, Oct 28, 2026)](https://etfiq.com/compare/any/vht-vs-xlv)
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