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.

Data updated September 4, 2026

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

VHT has outpaced XLV over the trailing twelve months, posting a 28.46% total return against 27.41%. The lead holds up over 10 years too: VHT has compounded at 10.80% a year, against 10.77% for XLV. 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.
Symbol	YTD	1Y	3Y	5Y	10Y	Since Jan 2004	Volatility	Sharpe	Sortino	Max drawdown
VHT	12.20%	28.46%	11.54%	5.43%	10.80%	10.12%	14.6%	0.44	0.63	-16.9%
XLV	11.19%	27.41%	10.90%	6.32%	10.77%	9.67%	14.7%	0.40	0.58	-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 September 4, 2026. YTD and 1Y are cumulative; windows of one year or longer are annualized. “Since Jan 2004” measures every fund from January 30, 2004 — the youngest fund's first trading day — 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.
Metric	VHT	XLV
Full name	Vanguard Health Care ETF	State Street Health Care Select Sector SPDR ETF
Issuer	Vanguard	State Street
Underlying index	MSCI US Investable Market Health Care 25/50 Index	Health Care Select Sector Index
Last Close	$321.66 as of September 4, 2026	$171.45 as of September 4, 2026
Distribution yield	1.23%	1.53%
Distribution Safety Score™	100	100
Safety-Adjusted Yield	1.23%	1.53%
Expense ratio	0.09%	0.08%
AUM	$19.4B	$44.5B
Distribution frequency	Quarterly	Quarterly
Objective	Tracks the MSCI US Investable Market Health Care 25/50 Index.	Provide exposure to the fund's underlying index or strategy per issuer materials.
Asset class	Equity	Equity
Inception date	01/26/2004	12/16/1998
Beta	0.57	0.51
Last dividend	$0.987	$0.656
Ex-dividend date	06/24/2026	06/22/2026

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.

	VHT	XLV
Index	MSCI US Investable Market Health Care 25/50 Index	Health Care Select Sector Index
Expense ratio	0.09%	0.08%
Distribution yield	1.23%	1.53%

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Vanguard

ETFs116

Total AUM$4650B

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.

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State Street

ETFs179

Total AUM$2124B

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.

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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 1.53% vs 1.23% 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 ($44.5B), which generally means tighter spreads and better liquidity.

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Deep dive

Yield & income

On a $10,000 investment, VHT would generate roughly $10.25/month, while XLV would produce $12.75/month, at current distribution rates. Both pay quarterly distributions.

VHT yield1.23%

XLV yield1.53%

Monthly diff on $10K$2.50

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 0.51 for XLV, making XLV the less volatile of the two by this measure.

VHT beta0.57

XLV beta0.51

Fund details

VHT is managed by Vanguard (launched 01/26/2004) with $19.4B in assets. XLV is managed by State Street (launched 12/16/1998) with $44.5B in assets.

VHT AUM$19.4B

XLV AUM$44.5B

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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 1.23% and 1.53% as of September 2026. Breadth versus a large-cap sector sleeve is the decision.

What is the current distribution yield for VHT and XLV?

VHT currently distributes 1.23% and XLV 1.53%, based on fund data updated September 2026. Distribution yield 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 100, XLV scores 100. 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 $10.25 per month ($123.00 annually). The same in XLV would produce about $12.75 per month ($153.00 annually).

Which has performed better historically, VHT or XLV?

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VHT vs XLV — at a glance

Generated August 29, 2026.

Overview

VHT and XLV are both healthcare equity ETFs tracking broad market indexes, but they differ meaningfully in scope and composition. VHT tracks the MSCI US Investable Market Health Care 25/50 Index, which includes small, mid, and large-cap healthcare stocks with diversification constraints. XLV tracks the Health Care Select Sector Index, which represents the healthcare holdings of the S&P 500 only—a large-cap-heavy universe. The result is that VHT casts a wider net across the healthcare landscape, while XLV focuses on the sector's mega-cap leaders.

How they differ

The core distinction is breadth: VHT includes small and mid-cap healthcare names alongside large-caps, whereas XLV's index includes only S&P 500 constituents, tilting the portfolio toward household names like UnitedHealth, Eli Lilly, and Johnson & Johnson. This makes XLV materially more concentrated in mega-cap exposure. XLV's yield of 1.53% exceeds VHT's 1.23%, though both distribute quarterly; XLV is also larger ($44.5B in AUM vs. VHT's $19.4B). VHT has a beta of 0.57 compared to XLV's 0.51, suggesting VHT carries modestly more systematic risk—consistent with its broader inclusion of smaller-cap healthcare equities, which tend to swing a bit more sharply in market moves.

Who each is best for

VHT: Fits investors seeking healthcare sector exposure across the market-cap spectrum and preferring exposure to smaller healthcare companies alongside large-cap holdings.

XLV: Designed for investors comfortable with concentration in large-cap healthcare leaders and attracted to a larger, more liquid fund with a modestly higher current yield and lower volatility profile.

Key risks to know

Index concentration in large-cap names. XLV's S&P 500-only framework concentrates exposure in a smaller set of mega-cap healthcare firms; if large-cap healthcare valuations contract sharply, the impact on XLV may be steeper than on VHT's broader market-cap universe.

Small and mid-cap liquidity for VHT. While VHT includes smaller healthcare stocks, those positions carry lower trading volume and wider bid-ask spreads than S&P 500 constituents, potentially increasing transaction costs during rebalances or large redemptions.

Sector-level earnings and regulatory risk. Both ETFs are exposed to pharmaceutical pricing pressure, healthcare-policy uncertainty, and FDA approval risk; their beta values of 0.51–0.57 do not insulate them from sector-wide shocks (e.g., drug-pricing legislation or reimbursement cuts).

Yield sustainability across market cycles. Healthcare dividend growth has historically lagged broad equity, and both distributions rely on earnings that can compress during economic slowdowns; current yields should not be assumed stable if sector earnings decline.

Bottom line

XLV offers larger AUM, higher yield, and slightly lower volatility through mega-cap healthcare leaders; VHT exposes investors to a broader cross-section of healthcare company sizes. If you value established large-cap healthcare exposure with strong liquidity, XLV's structure fits that profile; if you want exposure across market-cap tiers within healthcare, VHT's wider index membership stands out. Past performance doesn't predict future results.

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

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