VHT vs XLV: Fees, Returns & Holdings Compared

	Expense ratio	Net assets	Yield (TTM)	Overlap	1 yr	5 yr*
VHT	0.09%	$22.04B	1.35%	85%	+28.9%	+7.3%
XLV	0.08%	$40.60B	1.38%		+30.2%	+8.4%

At a glance

85% of VHT’s and XLV’s holdings overlap by weight, with 59 securities in common out of 417 and 59. XLV is an ordinary open-end ETF and VHT a share class of Vanguard Health Care Index Fund, which also sells mutual fund shares. XLV costs less: 0.08% a year against 0.09% for VHT, or $80 against $90 on every $100,000. VHT has $22.04B in assets (all share classes) and XLV $40.60B; over the past 12 months VHT paid out 1.35% of its price and XLV 1.38%, both quarterly. Over the past year VHT returned +28.9% and XLV +30.2% with distributions reinvested; over five years, +7.3% and +8.4% a year. In the 2022 bear market VHT fell 17.0% at its worst and XLV 16.1%; both were back at their earlier highs 19 months after the low.

Key differences

	VHT	XLV
Fund	Vanguard Health Care ETF	Health Care Select Sector SPDR Fund
Issuer	Vanguard	SPDR (State Street)
Structure	ETF share class	Open-end ETF
Type	Health care	Health care
Launched	Jan 26, 2004	Dec 16, 1998
Expense ratio	0.09%	0.08%
Cost a year on $100,000	$90	$80
Net assets	$22.04B *	$40.60B
Holdings	417	59
Ten largest positions	51.7%	61.5%
Yield (12 months)	1.35%	1.38%
Pays	quarterly	quarterly
Portfolio turnover	4% a year	2% a year
Price data from	Jun 2, 2020	Jun 2, 2020

* VHT’s net assets are those of Vanguard Health Care Index Fund, all share classes.

Holdings and overlap

Overlap by weight85%the share of each fund in holdings both own

Securities in common59VHT 417 · XLV 59 in all

Ten largest positions51.7% / 61.5%of assets, VHT / XLV

Overlap adds up, for every security both funds own, the smaller of its two weights: 100% would mean identical portfolios.

Largest holdings

Holding	VHT	XLV
Eli Lilly & Co	12.87%	16.51%
Johnson & Johnson	8.75%	10.64%
AbbVie Inc	6.28%	7.74%
UnitedHealth Group Inc	4.90%	6.57%
Merck & Co Inc	5.06%	5.52%
Amgen Inc	3.21%	3.40%
Thermo Fisher Scientific Inc	3.18%	3.24%
Abbott Laboratories	2.66%	2.75%
Gilead Sciences Inc	2.52%	2.73%
Intuitive Surgical Inc	1.85%	2.45%
Pfizer Inc	2.24%	2.39%

The biggest differences in weight: Eli Lilly & Co (12.9% in VHT, 16.5% in XLV); Johnson & Johnson (8.7% in VHT, 10.6% in XLV); UnitedHealth Group Inc (4.9% in VHT, 6.6% in XLV).

By sector

Sector	VHT	XLV	Difference
Health care	68.0%	79.8%	XLV +11.8
Technology	0.6%	0.5%	VHT +0.1

Sectors of the companies each fund holds that have a stock page here (76% of VHT, 89% of XLV). Source: N-PORT holdings reports as of Aug 31, 2026 (VHT) and Jun 30, 2026 (XLV).

Returns

VHT XLV · $10,000 in each on Jun 30, 2020, distributions reinvested.

$10,000 put into VHT on Jun 30, 2020 was worth $19,432 on Oct 30, 2026, and in XLV $20,418 (+11.1% and +11.9% a year). That is as far back as the price data for both goes.

	1 yr	3 yr	5 yr	10 yr
VHT price data to Oct 30, 2026	+28.9%	+16.9%	+7.3%	—
VHT official prospectus, to Dec 31, 2024	+2.65%	—	+7.20%	+8.83%
XLV price data to Oct 30, 2026	+30.2%	+16.2%	+8.4%	—
XLV official prospectus, to Dec 31, 2025	+14.51%	—	+8.10%	+9.75%

Multi-year figures are annualized total returns with distributions reinvested. "Official" rows are the SEC-standard returns from each fund's prospectus, to the end of the last calendar year; they reach back further where the price data starts late. VHT: Price data starts 2020-06-02, after the fund's launch on 2004-01-26; figures "since start" cover the available history only. XLV: Price data starts 2020-06-02, after the fund's launch on 1998-12-16; figures "since start" cover the available history only.

Calendar years

Year	VHT	XLV	Difference
2026	+20.1% *	+20.9% *	XLV +0.8
2025	+15.5%	+14.5%	VHT +1.0
2024	+2.7%	+2.5%	VHT +0.2
2023	+2.5%	+2.1%	VHT +0.4
2022	-5.6%	-2.1%	XLV +3.5
2021	+20.6%	+26.0%	XLV +5.5
2020	+18.21% †	+13.27% †	VHT +4.9
2019	+21.97% †	+20.66% †	VHT +1.3
2018	+5.55% †	+6.29% †	XLV +0.7
2017	—	+21.70% †

Total returns from price data; † from the fund’s prospectus where the price data starts later; * year to Oct 30, 2026.

Downturns and recovery

	VHT	XLV
2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009	Not in the price data (starts Jun 2, 2020)	Not in the price data (starts Jun 2, 2020)
2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020	Not in the price data (starts Jun 2, 2020)	Not in the price data (starts Jun 2, 2020)
2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022	−17% at the worst; back at its high 19 months after the low	−16.1% at the worst; back at its high 19 months after the low
Worst fall in the price data	−17.7% (Dec 30, 2021 – Jun 16, 2022)	−17.1% (Sep 16, 2024 – May 14, 2025)

The deepest drop from a high to a low during each stretch when stocks fell, and how long the fund took to get back to its earlier high, with distributions reinvested. The price data starts Jun 2, 2020 for VHT and Jun 2, 2020 for XLV.

Income

VHT yield (12 months)1.35%paid quarterly

XLV yield (12 months)1.38%paid quarterly

Year	VHT	XLV
2025	$183	$180
2024	$155	$168
2023	$137	$160
2022	$123	$142
2021	$136	$166

Distributions paid during each calendar year on $10,000 of shares bought at the previous year-end close, adjusted for share splits. Before taxes.

Costs

XLV charges 0.08% a year and VHT 0.09%: on $100,000 that is $10 a year less with XLV ($50 on $500,000). The fee comes out of each fund's assets, so it is already in the returns above.

Cost of $10,000 (SEC example)	1 yr	3 yrs	5 yrs	10 yrs
VHT	$9	$29	$51	$115
XLV	$8	$26	$45	$103

From each fund's prospectus: the total costs on $10,000 invested, at a 5% yearly return, with the shares sold at the end of each period.

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