At a glance
VHT charges 0.09% a year, below the 0.42% average of the 8 funds most like it (the 3rd cheapest of 9). It has $22.04B in assets, the 2nd largest of that group; it paid 1.35% of its price in distributions over the past 12 months, quarterly. Over the past year it returned +28.9% with distributions reinvested (S&P 500: +11.5%), 3rd of those 9 funds; over three years it returned +16.9% a year. At its worst it fell 17.0% in the 2022 bear market (S&P 500: 24.5%), and was back at its earlier high 19 months after the low. Its ten largest positions make up 51.7% of the fund, out of 417 in all.
The short version
Vanguard Health Care ETF (VHT) is an index fund that tracks the MSCI US Investable Market Index (IMI)/Health Care 25/50, covering large, mid-size and small US health care companies. Its 0.09% annual expense ratio sits far below the 0.42% average for similar funds, though near rivals such as XLV (0.08%). It is top-heavy: as of August 31, 2026, Eli Lilly alone was 12.9% of assets and the top 10 holdings about 52%.
Price history
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VHT +28.9% over the year to Oct 30, 2026, total return with distributions reinvested.
How it has behaved
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | Since start | |
|---|---|---|---|---|---|---|
| VHT official prospectus, to Dec 31, 2024 | — | +2.65% | — | +7.20% | +8.83% | — |
| VHT price data to Oct 30, 2026 | +20.1% | +28.9% | +16.9% | +7.3% | — | +10.7% |
- Over the year to Oct 30, 2026, VHT returned +28.9%, 3rd of 9 among similar funds.
- Its 5-year annualized return was +7.3%.
- Its worst full calendar year was 2022 (-5.6%); its best was 2021 (+20.6%).
- The deepest fall in its price history was 17.7% (Dec 30, 2021 to Jun 16, 2022), recovered by Feb 6, 2024.
Show as a table
| Year | Price data | Prospectus (official) |
|---|---|---|
| 2026 (to date) | +20.1% | — |
| 2025 | +15.5% | — |
| 2024 | +2.7% | +2.65% |
| 2023 | +2.5% | +2.47% |
| 2022 | -5.6% | -5.52% |
| 2021 | +20.6% | +20.50% |
| 2020 | — | +18.21% |
| 2019 | — | +21.97% |
| 2018 | — | +5.55% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Not in the price data, which starts Jun 2, 2020 |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Not in the price data, which starts Jun 2, 2020 |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Lost 14.5% over that stretch · deepest drop along the way 17%, back to its old high 18.8 months after the low |
Dividends and income
Show as a table
| Year | Per share | Change |
|---|---|---|
| 2026 (to date) | $2.9500 | |
| 2025 | $4.6500 | +19.8% |
| 2024 | $3.8800 | +13.8% |
| 2023 | $3.4100 | +3.6% |
| 2022 | $3.2900 | +7.9% |
| 2021 | $3.0500 |
What's inside
As of Aug 31, 2026, the fund held 417 securities; the ten largest made up 51.66% of assets.
| Holding | Weight | |
|---|---|---|
| Eli Lilly & Co | 12.87% | |
| Johnson & Johnson | 8.75% | |
| AbbVie Inc | 6.28% | |
| Merck & Co Inc | 5.06% | |
| UnitedHealth Group Inc | 4.90% | |
| Amgen Inc | 3.21% | |
| Thermo Fisher Scientific Inc | 3.18% | |
| Abbott Laboratories | 2.66% | |
| Gilead Sciences Inc | 2.52% | |
| Pfizer Inc | 2.24% | |
| Vertex Pharmaceuticals Inc | 1.92% | |
| Bristol-Myers Squibb Co | 1.89% | |
| Danaher Corp | 1.88% | |
| Intuitive Surgical Inc | 1.85% | |
| CVS Health Corp | 1.65% |
By country
United States 99.77%Switzerland 0%By asset type
Stocks 99.77%By sector
Sectors of the companies held, for the 76% of the fund in companies that have a stock page here; other holdings and cash aren't classified. Source: N-PORT holdings report as of Aug 31, 2026. Cash, money-market funds and derivatives are shown separately from the securities list.What changed recently
- Over the three months to Aug 31, 2026, investors added a net $314.1M (creations minus redemptions, per the N-PORT report).
- Monthly total returns reported for that quarter: +7.33%, +1.85%, +4.97%.
How it works
VHT is the exchange-traded share class of Vanguard Health Care Index Fund, so it shares one portfolio with the fund's other share classes. The fund aims to track the MSCI US Investable Market Index (IMI)/Health Care 25/50. That index holds large, mid-size and small US companies in the health care sector as defined by the Global Industry Classification Standard (GICS), which sorts companies by industry. The sector includes drugmakers, biotech firms, medical equipment companies, health care services and health care technology.
The fund attempts to replicate the index by holding all or substantially all of its stocks in about the same proportions. It normally keeps at least 80% of net assets in index stocks. Because it mirrors the index's weights, a few giants dominate. As of August 31, 2026, it held 417 stocks, yet Eli Lilly (12.9%), Johnson & Johnson (8.7%) and AbbVie (6.3%) led, and the top 10 made up 51.7%. The “25/50” in the index name refers to a common capping rule for sector indexes that limits how much weight the largest companies can carry.
Holdings change mainly when the index does, so trading is light. The prospectus filed December 19, 2025 reports portfolio turnover of 4%, meaning roughly 4% of holdings were replaced over a year. Shares trade on NYSE Arca at market prices, which can differ slightly from the value of the stocks inside.
What it really costs
- VHT charges 0.09% a year, versus an average of 0.42% for the similar funds below (3rd of 9, cheapest first).
- Of that, 0.08% is the management fee; the rest covers other fund expenses.
- Using the prospectus's standard example, $10,000 invested would cost about $9 in the first year and $115 over 10 years (assuming a 5% annual return).
| Cost of $10,000 (SEC example) | 1 yr | 3 yrs | 5 yrs | 10 yrs |
|---|---|---|---|---|
| VHT | $9 | $29 | $51 | $115 |
In a retirement portfolio
It holds a single US sector and puts about 13% in one company, so it fits better as a tilt beside a broad core fund than as the core itself.
VHT may add a low-cost tilt toward US health care. It costs 0.09% a year, or $115 over 10 years on $10,000 in the SEC's standard example. The price record here starts in June 2020, so it misses the 2008 crisis. The prospectus does show a 13.15% loss in the first quarter of 2020. From the stock market's January 2022 peak to its October 2022 low, VHT lost 14.5%. Yet it ended 2022 down 5.52%, its worst calendar year back to 2018. Its deepest drop since June 2020 was 17.7%. It took about 20 months, until February 2024, to regain the old high. Anyone withdrawing during such a stretch would be cashing out shares at lower prices.
Income is modest: a 1.35% yield over the year to October 29, 2026, paid quarterly. Past results don't predict future ones, and a plan should consider the whole portfolio, not one fund.
Who it may suit — and who should look elsewhere
May suit
- Investors seeking broad US health care exposure, from giants like Eli Lilly and Johnson & Johnson to smaller companies, across hundreds of stocks.
- Retirement savers adding a health care tilt beside a broad core fund; its worst calendar year since 2018 was a 5.52% loss in 2022.
- Cost-focused investors: the 0.09% expense ratio is far below the 0.42% average of similar funds and close to XLV's 0.08% and FHLC's 0.084%.
Look elsewhere if
- Investors wary of single-stock risk: Eli Lilly alone was 12.9% of assets as of August 31, 2026, and the top 10 holdings about 52%.
- Income seekers: the yield was 1.35% over the year to October 29, 2026, paid quarterly, modest for anyone relying on dividends for spending.
- Investors wanting non-US health care companies: VHT was 99.77% US stocks as of August 31, 2026; global fund IXJ is worth comparing.
Close alternatives
Matched by holdings overlap from the latest N-PORT reports.
| Fund | Overlap | Cost | Net assets | 1 yr | 3 yr |
|---|---|---|---|---|---|
| VHT this fund | — | 0.09% | $22.04B | +28.9% | +16.9% |
| FHLC Fidelity MSCI Health Care Index ETF | 96% | 0.084% | $3.29B | +23.8% | +16.0% |
| IYH iShares U.S. Healthcare ETF | 87% | 0.39% | $3.56B | +23.8% | +15.0% |
| XLV Health Care Select Sector SPDR Fund | 85% | 0.08% | $40.60B | +30.2% | +16.2% |
| IXJ iShares Global Healthcare ETF | 71% | 0.41% | $3.84B | +19.5% | +13.4% |
| JDOC JPMorgan Healthcare Leaders ETF | 53% | 0.65% | $9.1M | +15.7% | — |
| RSPH Invesco S&P 500 Equal Weight Health Care ETF | 49% | 0.4% | $766.9M | +28.4% | +16.6% |
| FTXH First Trust Nasdaq Pharmaceuticals ETF | 46% | 0.6% | $36.2M | +46.9% | +23.4% |
Compared head to head: VHT vs XLV · all comparisons →
Questions investors ask
What's the difference between VHT and XLV?
They cost almost the same and hold largely the same companies. VHT charges 0.09% a year versus 0.08% for XLV, and 85% of their holdings overlap. VHT tracks the MSCI US Investable Market Index (IMI)/Health Care 25/50, which includes small and mid-size companies, and held 417 stocks as of August 31, 2026. As of October 29, 2026, VHT returned 28.9% over one year and 17.1% a year over three, against 29.9% and 16.2% for XLV. Fidelity's FHLC overlaps even more, at 96%, and costs 0.084%.
Does VHT pay monthly dividends?
No. VHT pays dividends quarterly. In the year to October 29, 2026, it paid $4.62 per share, a yield of 1.35%. The yield is those payouts divided by the share price. That is modest income: the fund follows its index and does not pick stocks for their dividends. Payouts pass through dividends from the stocks it owns, so they can rise or fall from year to year.
What is VHT's expense ratio?
VHT's expense ratio, the yearly fee taken from fund assets, is 0.09%, per its prospectus filed December 19, 2025. The SEC's standard example assumes $10,000 invested, a 5% annual return and shares cashed out at the end of each period. On that basis, costs total $9 after one year, $51 after five and $115 after 10. That ranks third-lowest of nine comparable funds; the other eight average 0.42%. XLV (0.08%) and FHLC (0.084%) cost slightly less, while IYH charges 0.39%.
What are the top 10 holdings in VHT?
As of August 31, 2026, VHT's largest holdings were Eli Lilly (12.9%), Johnson & Johnson (8.7%), AbbVie (6.3%), Merck (5.1%) and UnitedHealth Group (4.9%). Next came Amgen, Thermo Fisher Scientific, Abbott Laboratories, Gilead Sciences and Pfizer. Those 10 made up 51.7% of assets, out of 417 stocks in total. That concentration means news at one or two of the biggest companies, especially Eli Lilly, can move the whole fund noticeably.
What is VHT's 10-year return?
VHT returned an average of 8.83% a year over the 10 years to December 31, 2024, according to its prospectus, and 7.2% a year over five years. Calendar-year results since 2018 ranged from a 21.97% gain in 2019 to a 5.52% loss in 2022, with slim gains in 2023 (2.47%) and 2024 (2.65%). Market-price returns were stronger afterward: 15.47% in 2025 and 20% for 2026 through October 29. Past returns don't predict future results.