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ETF Comparison

VHT vs XLV: Broad Health Care, or the Sector Sleeve?

A head-to-head of Vanguard Health Care and the Health Care Select Sector SPDR covering construction, cost, and concentration.

Updated October 16, 2026

How these figures are calculated: methodology.

Best for

  • VHTInvestors who want broad equity exposure.
  • XLVInvestors who want broad equity exposure.

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Visual comparison

Key metrics

Projected income on $10K

Projections assume the current yield and share price remain constant. Actual results will vary.

Total returns

100% reinvested · ex-date convention. Period returns use this fixed assumption, independent of chart settings. YTD and 1Y are cumulative period returns; 3Y, 5Y, and 10Y are annualized. The shared Since-start window is annualized only when it covers at least one year.

VHT has lagged XLV over the trailing twelve months, posting a 24.89% total return against 26.24%. The lead holds up over 10 years too: XLV has compounded at 11.61% a year, against 11.49% for VHT. Figures are total returns: price change plus every distribution reinvested.

Total return and risk statistics by fund. Each row is one fund; each column is one period or statistic.
SymbolYTD cumulative1Y cumulative3Y annualized5Y annualized10Y annualizedSince Jan 2004Volatility Sharpe Sortino Max drawdown
VHT14.82%24.89%12.91%7.21%11.49%10.16%14.8%0.540.78-16.9%
XLV15.57%26.24%12.30%8.41%11.61%9.79%14.9%0.500.72-17.1%

Total return with all distributions reinvested on the ex-dividend date (a modeling convention, not the cash-settlement date), split-adjusted, as of October 16, 2026. YTD and 1Y are cumulative period returns; 3Y, 5Y, and 10Y are annualized. The shared Since-start window is annualized only when it covers at least one year. “Since Jan 2004” measures every fund from January 30, 2004 — the start of shared available history — so all funds share one comparison window. Volatility is the annualized standard deviation of daily total returns over the trailing 3 years. Sharpe and Sortino divide the annualized return in excess of the risk-free rate by, respectively, that volatility and the downside deviation (both over the trailing 3 years) — higher is better. Max drawdown is the largest peak-to-trough total-return decline over the same window — shallower is better.

Side-by-side snapshot

Side-by-side snapshot. Each row is one metric; each column is one fund.
MetricVHTXLV
Full nameVanguard Health Care ETFState Street Health Care Select Sector SPDR ETF
IssuerVanguardState Street
Underlying indexMSCI US Investable Market Health Care 25/50 IndexHealth Care Select Sector Index
Last Close$327.15 as of October 16, 2026$176.71 as of October 16, 2026
Distribution rate1.18%1.45%
Trailing 12-month yield1.41%1.44%
Distribution Safety Score™ 9797
Safety-Adjusted Yield 1.14%1.41%
Expense ratio0.09%0.08%
AUM$18.9B$44.3B
Distribution frequencyQuarterlyQuarterly
ObjectiveTracks the MSCI US Investable Market Health Care 25/50 Index.Provide exposure to the fund's underlying index or strategy per issuer materials.
Asset classEquityEquity
Inception date01/26/200412/16/1998
Beta0.570.52
Last dividend$0.969$0.642
Ex-dividend date09/23/202609/21/2026

Bottom lineVHT and XLV are both for investors who want broad equity exposure — so strategy isn't the deciding factor here. Fees and payouts are close too, so it comes down to which your broker offers commission-free and any share-price or tax-lot preference.

VHT vs XLV: broad health care or the sector sleeve?

VHT is a broader health-care market. XLV is the select-sector book. Breadth is the decision.

VHTXLV
IndexMSCI US Investable Market Health Care 25/50 IndexHealth Care Select Sector Index
Expense ratio0.09%0.08%
Distribution rate1.18%1.45%
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See how much monthly income a hypothetical investment would generate in each ETF at current yields.

Vanguard
ETFs116
Total AUM$4.66T

ETFs and AUM reflect what Dividend Vision tracks — the issuer's full lineup may be larger.

Vanguard is one of the largest and most established ETF issuers, known for low-cost, broadly diversified fund offerings built on passive indexing principles. Their lineup spans multiple asset classes and strategies, including core equity and bond index funds, dividend-focused portfolios, ESG-screened options, factor-based strategies, sector exposure, target-date retirement funds, and international investments across developed and emerging markets. The platform is characterized by its emphasis on accessibility and cost efficiency across a comprehensive range of fund families, serving both individual investors seeking broad market exposure and those pursuing specific income, sustainability, or thematic objectives.

See our curated list of related YouTube videos on VHT.

See all ETFs from Vanguard
State Street
ETFs186
Total AUM$2.15T

ETFs and AUM reflect what Dividend Vision tracks — the issuer's full lineup may be larger.

State Street Global Advisors (SSGA) is one of the largest ETF providers globally, known for its flagship SPDR suite of exchange-traded products that serve both institutional and retail investors across a broad range of asset classes. Their 88-fund lineup spans diverse strategies including sector exposure (Select Sector SPDR), income generation (Income and Select Sector SPDR Premium Income families), commodities (including the widely-held GLD gold ETF), bonds, ESG-focused investments, and thematic allocations, with popular tickers like DIA (Diamonds Trust), FEZ (Eurozone exposure), and JNK (high-yield bonds) among their most recognized funds. The issuer is characterized by its comprehensive coverage across multiple market segments and its emphasis on both traditional index-based products and specialized strategies like covered call income funds and factor-based investing.

See our curated list of related YouTube videos on XLV.

See all ETFs from State Street

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Quick verdict

VHT (Vanguard Health Care ETF) and XLV (State Street Health Care Select Sector SPDR ETF) are both quarterly-pay dividend ETFs, but they take different approaches.

XLV offers the higher yield at 1.45% vs 1.18% for VHT. A higher yield means more current income per dollar invested, though it may come with different risk characteristics.

XLV is cheaper with an expense ratio of 0.08% compared to 0.09%.

They have different reference exposures: VHT is linked to MSCI US Investable Market Health Care 25/50 Index while XLV is linked to Health Care Select Sector Index, which means their performance drivers differ.

XLV is the larger fund by assets ($44.3B), but assets alone do not establish trading costs or liquidity.

Deep dive

Yield & income

On a $10,000 investment, VHT would generate roughly $29.50 cash per distribution, while XLV would produce $36.25 cash per distribution, at current distribution rates. Both pay quarterly distributions.

VHT yield1.18%
XLV yield1.45%
Cash diff on $10K$6.75

Cost & efficiency

Over 10 years on $10,000, VHT would cost approximately $90 in fees vs $80 for XLV (simplified, not compounded). The $10.00 difference may be offset by yield or performance.

VHT ER0.09%
XLV ER0.08%

Strategy & risk

VHT tracks MSCI US Investable Market Health Care 25/50 Index, while XLV tracks Health Care Select Sector Index with an index approach. Beta is 0.57 for VHT and 0.52 for XLV — effectively similar market sensitivity.

VHT beta0.57
XLV beta0.52

Fund details

VHT is managed by Vanguard (launched 01/26/2004) with $18.9B in assets. XLV is managed by State Street (launched 12/16/1998) with $44.3B in assets.

VHT AUM$18.9B
XLV AUM$44.3B
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Frequently asked questions

What is the difference between VHT and XLV?

VHT (Vanguard Health Care ETF) tracks a broad US health-care market index. XLV (State Street Health Care Select Sector SPDR ETF) holds the health care select sector. Cost is 0.09% versus 0.08%; distributions are 1.18% and 1.45% as of October 2026. Breadth versus a large-cap sector sleeve is the decision.

What is the current distribution rate for VHT and XLV?

VHT currently distributes 1.18% and XLV 1.45%, based on fund data updated October 2026. Distribution rate moves with both the payout and the share price, so check the as-of date before relying on either figure.

Is VHT or XLV better for dividend income?

It depends on your goals. XLV currently offers the higher distribution yield, which means more income per dollar invested. However, a lower-yield fund may offer better total return or lower volatility. Consider your time horizon and risk tolerance.

Can I hold both VHT and XLV?

Yes — nothing prevents holding both. Whether the combination actually diversifies depends on how much the underlying exposures overlap, which isn't fully measurable from the data on this page; review each security's holdings, sector, and strategy before treating them as complementary.

Is VHT or XLV safer?

By Dividend Vision's Distribution Safety Score — a rules-based 0–100 estimate of how resilient a distribution looks, where higher is safer — they are effectively tied: VHT scores 97, XLV scores 97. Neither has a clear safety edge on that measure. No score makes an investment risk-free — treat this as a screening signal, not a guarantee.

Which has lower fees, VHT or XLV?

VHT has an expense ratio of 0.09% while XLV charges 0.08%. Lower fees mean more of your investment returns stay in your pocket over time.

How much income does $10,000 in VHT vs XLV generate?

At current rates, $10,000 in VHT would generate roughly $29.50 cash per distribution ($118.00 annually). The same in XLV would produce about $36.25 cash per distribution ($145.00 annually).

Which has performed better historically, VHT or XLV?

VHT has lagged XLV over the trailing twelve months, posting a 24.89% total return against 26.24%. The lead holds up over 10 years too: XLV has compounded at 11.61% a year, against 11.49% for VHT. Figures are total returns: price change plus every distribution reinvested. Past performance does not guarantee future results.

More comparisons to explore

VHT vs XLV — at a glance

Generated October 17, 2026.

Overview

VHT and XLV are both large, passively managed healthcare equity ETFs tracking different healthcare indexes. The key distinction is breadth: VHT's index includes mid-cap and smaller healthcare companies alongside large caps, while XLV focuses exclusively on large-cap names in the S&P 500.

How they differ

VHT and XLV differ first in index methodology and universe size. VHT's MSCI index captures healthcare across the full investable market with concentration limits (25% and 50% caps on individual and cumulative top holdings), while XLV's sector index pulls only from S&P 500 constituents, tilting exposure toward mega-cap names. XLV yields 1.45% compared to VHT's 1.18%, a difference of 0.27% percentage points. XLV holds a larger asset base at $44.3B versus VHT's $18.9B, and is slightly cheaper to own at 0.08% versus 0.09%. VHT shows marginally higher beta at 0.57 compared to XLV's 0.52, reflecting greater sensitivity to market moves—likely due to broader exposure beyond the largest-cap names.

Who each is best for

VHT: Fits investors seeking diversified healthcare exposure that extends beyond mega-cap names, valuing the ability to capture mid-cap healthcare growth and innovation outside the S&P 500 core.

XLV: Fits investors who want large-cap healthcare sector exposure aligned with S&P 500 holdings and are comfortable with a heavier weighting toward dominant healthcare companies.

Key risks to know

  • Index concentration and cap effects. XLV's S&P 500 sector index concentrates exposure in a smaller number of mega-cap healthcare firms; VHT's broader market index with 25/50 concentration limits distributes risk more evenly. An outperformance or underperformance by the handful of largest healthcare names will have outsized impact on XLV returns.
  • Different company profiles drive style drift. VHT's exposure to mid-cap and smaller healthcare companies introduces different growth, profitability, and volatility characteristics than XLV's large-cap anchors. Holdings and sector weightings between the two are not identical, making them imperfect substitutes for the same "healthcare bet."
  • Large-cap healthcare regulatory and valuation risk. Both funds are exposed to healthcare policy changes and drug pricing pressure, but XLV's concentration in mega-cap pharmaceutical, biotech, and medical device manufacturers means regulatory headwinds or patent cliffs at a few major holdings can meaningfully drag returns.

Bottom line

If you want comprehensive healthcare market exposure including mid-cap innovators and a more balanced holding structure, VHT's broader index construction stands out. If you prefer to track large-cap healthcare as defined by the S&P 500 and don't mind the higher yield and slightly lower cost, XLV aligns with that focus. Both offer minimal expense ratios and quarterly dividends, so the choice hinges on whether you want the full healthcare market or just its largest players. Past performance does not predict future returns.

AI-generated analysis for educational purposes only. Verify important details independently; past performance does not guarantee future results.

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How to read a fund's stats How expense ratios eat returns Correlation between two funds

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These comparisons follow the Dividend Vision methodology.