VHT vs XHE: Grades, Fees and Holdings Compared

Vanguard Health Care ETF

VHTANYSE Arca

State Street SPDR S&P Health Care Equipment ETF

XHEBNYSE Arca

Overlap

13.5%by weight

Expense ratio

VHT −0.26pt a year

VHT0.09%XHE0.35%

Avg volume · 30D

VHT 8.0×the volume

VHT237KXHE29.7K

10Y return · a year

VHT +5.6pt

VHT+12.4%XHE+6.8%

VHT vs XHE Performance

Oct 29, 2021 – Oct 30, 2026

+42.5%VHT−27.4%XHE

Expense ratio: VHT 0.09%, better; XHE 0.35%
Fund size: VHT $21.8B; XHE $157M
1Y total return: VHT +28.7%, better; XHE +14.3%
Yield (12M): VHT 1.35%, better; XHE 0.02%
Holdings: VHT 413; XHE 75
Avg volume (30D): VHT 237K sh, better; XHE 29.7K sh
NAV per share: VHT $342.46; XHE $95.12
52W range

ETF.net Grade

Pillar letters and Scores for VHT, XHE, with each pillar’s weight
Pillar	VHT	XHE
Cost30% weight	A92Higher	A81
Mission25% weight	A82	Not scored
Risk15% weight	A79Higher	D27
Tradability15% weight	B57Higher	C50
Holdings10% weight	B58	A93Higher
Durability5% weight	A92Higher	B68

Rank among Health Care (Broad) funds

How we build Categories ›

Same Category. VHT and XHE are both graded against the same 25 Health Care (Broad) funds, so their Grades compare head to head.

Health Care (Broad)⁠

Category · 25 funds

See all 25 ›

VHT ranks 3rd and XHE 9th of 25 funds in the Health Care (Broad) Category.

Rank 1AXLVState Street Health Care Select Sector SPDR ETFScore 85
Rank 2AFHLCFidelity MSCI Health Care Index ETFScore 83
Rank 3AVHTVanguard Health Care ETFScore 77
Rank 4AXHSState Street SPDR S&P Health Care Services ETFScore 74
Rank 8BPSCHInvesco S&P SmallCap Health Care ETFScore 67
Rank 9BXHEState Street SPDR S&P Health Care Equipment ETFScore 64
Rank 10BFXHFirst Trust Health Care AlphaDEX FundScore 58

Our read on each fund

ETF.net Research

VHTAVanguard Health Care ETF

XHEBState Street SPDR S&P Health Care Equipment ETF

In short

VHT The whole US health care sector in one ticket: roughly 400 stocks, an index that reaches well past the megacaps, and a nine-basis-point fee. Trading since 2004, it is one of the category's originals.

XHE Health care minus the pharma giants. XHE holds a focused basket of US medical device and supply makers at near-equal weight, so a small stent company gets roughly the same shelf space as an industry titan.

Stated mandate

VHT The fund seeks to track a benchmark index measuring the investment return of health care stocks.

XHE The fund seeks to match, before fees and expenses, the total return performance of the S&P Health Care Equipment Select Industry Index and provide exposure to the health care equipment segment of the S&P TMI.

Why people hold it

VHT Costs 0.09% a year while the typical fund in its health care peer group charges 0.50%. Same sector, a fraction of the toll.
Roughly 400 holdings drawn from an investable-market index, so mid and small health care companies count too, not just the sector's giants.vanguard.com
Two decades old, now a multi-billion-dollar fund, moderately traded, and it has hugged its benchmark closely. Pays out quarterly.
On cost, tracking and tradability together, it stands among the strongest builds in a 24-fund health care cohort.

XHE Modified equal weighting, reset on a quarterly schedule, keeps any one giant from dominating the basket. Small and mid-cap device names carry real weight here.ssga.com spglobal.com
0.35% a year, below the median for health care ETFs in its peer group. Unusual for a slice this narrow, where issuers often charge up.
A true pure play: equipment and supplies drawn from the S&P Total Market Index. No pharma, no insurers, no hospital chains diluting the theme.ssga.com
Launched in 2011 by State Street, so this one has traded through more than a decade of device-sector cycles rather than arriving with the latest theme.

Worth knowing

VHT FHLC and XLV each shave a basis point off the fee. If the fee line is your only tiebreaker, VHT is not the final word.
One sector, one news cycle. Drug pricing rules, patent expirations and regulatory decisions can move the entire basket at once.vanguard.com
Cap-weighted with a 25/50 diversification rule, so no single name can dominate outright, but the largest pharma and insurer positions still steer most of the ride.vanguard.com

XHE Broad health care ETFs like VHT, FHLC and XLV charge a fraction of this. The targeted device basket is what the extra costs buy.
Thinly traded next to the big sector funds, so spreads can widen when markets move fast.
One sub-industry, tilted toward smaller companies, and SSGA notes the fund can become non-diversified purely from index weight shifts.ssga.com

Full VHT profile⁠

Full XHE profile⁠

VHT vs XHE Holdings

How VHT and XHE differ

Overlap by weight

13.5%

Shared holdings make up 92.4% of XHE and 14.5% of VHT.

Level by level

Holdings63 in both13.5%
Sector4 Sectors98.5%
Asset classEquity100%
Countryby domicile100%

Sector

Sector weights in VHT and XHE, widest gap first
Sector	More in VHTMore in XHE	VHT	XHE
Financials	XHE +1.6 points	0.0%	1.6%
Health Care	VHT +1.6 points	100.0%	98.4%
Industrials	Same weight	0.0%	0.0%
Technology	Same weight	0.0%	0.0%

Country, concentration and asset class

Country by domicile

Country weights in VHT and XHE, widest gap first
Country	More in VHTMore in XHE	VHT	XHE
United States	Same weight	100.0%	100.0%

Concentration

Weight in the 10 largest Holdings

VHT51.8%
XHE18.1%

Securities held

VHT411
XHE73

Asset class

VHT: Equity
XHE: Equity

Holdings

Only in VHT348
In both63
Only in XHE10

Only in VHT

348 securities, 85.2% of VHT by weight

Eli Lilly & Co12.95%
Johnson & Johnson8.79%
AbbVie Inc6.46%
Merck & Co Inc5.02%
UnitedHealth Group Inc4.66%
Thermo Fisher Scientific Inc3.51%
Amgen Inc3.18%
Gilead Sciences Inc2.59%
Pfizer Inc2.27%
Danaher Corp1.97%
Vertex Pharmaceuticals Inc1.86%
Bristol-Myers Squibb Co1.78%
CVS Health Corp1.53%
McKesson Corp1.40%
Elevance Health Inc1.15%
Regeneron Pharmaceuticals Inc1.09%
Cigna Group/The1.01%
HCA Healthcare Inc0.93%
Moderna Inc0.91%
Natera Inc0.79%
Cencora Inc0.78%
Cardinal Health Inc0.73%
Agilent Technologies Inc0.68%
Humana Inc0.64%
IQVIA Holdings Inc0.63%
Waters Corp0.60%
Veeva Systems Inc0.58%
Illumina Inc0.56%
Revolution Medicines Inc0.49%
Biogen Inc0.47%
Alnylam Pharmaceuticals Inc0.46%
Centene Corp0.43%
Mettler-Toledo International Inc0.43%
Zoetis Inc0.41%
West Pharmaceutical Services Inc0.37%
Quest Diagnostics Inc0.36%
Labcorp Holdings Inc0.35%
Insmed Inc0.34%
Tenet Healthcare Corp0.31%
Guardant Health Inc0.31%
United Therapeutics Corp0.29%
Viatris Inc0.29%
Incyte Corp0.29%
Roivant Sciences Ltd0.27%
Revvity Inc0.24%
Medpace Holdings Inc0.20%
Charles River Laboratories International Inc0.20%
Exelixis Inc0.19%
Neurocrine Biosciences Inc0.19%
Jazz Pharmaceuticals PLC0.19%

Only in XHE

10 securities, 7.5% of XHE by weight

Beta Bionics Inc1.53%
Strive Inc A1.41%
Minimed Group Inc1.04%
Anteris Technologies Global1.03%
Delcath Systems Inc0.78%
Clearpoint Neuro Inc0.77%
Senseonics Holdings Inc0.57%
Neuropace Inc0.33%
Contra Paragon 28 Inc<0.01%
Contra Hologic Incorpo<0.01%

Weight gaps

All 63 Holdings in both funds, largest gap first.

Holding weights in VHT and XHE, widest gap first
Holding	More in VHTMore in XHE	VHT	XHE
Glaukos CorpGKOS	XHE +1.91 points	0.13%	2.04%
Alphatec Holdings IncATEC	XHE +1.89 points	0.02%	1.91%
Enovis CorpENOV	XHE +1.80 points	0.01%	1.81%
AtriCure IncATRC	XHE +1.74 points	0.04%	1.78%
Haemonetics CorpHAE	XHE +1.69 points	0.07%	1.76%
Omnicell IncOMCL	XHE +1.64 points	0.02%	1.66%
QuidelOrtho CorpQDEL	XHE +1.64 points	0.01%	1.65%
LeMaitre Vascular IncLMAT	XHE +1.60 points	0.02%	1.62%
Inspire Medical Systems IncINSP	XHE +1.60 points	0.02%	1.62%
STAAR Surgical CoSTAA	XHE +1.57 points	<0.01%	1.58%
IRhythm Holdings IncIRTC	XHE +1.57 points	0.05%	1.62%
Globus Medical IncGMED	XHE +1.56 points	0.12%	1.68%
UFP Technologies IncUFPT	XHE +1.56 points	0.03%	1.59%
Axogen IncAXGN	XHE +1.56 points	0.03%	1.59%
Tandem Diabetes Care IncTNDM	XHE +1.55 points	0.02%	1.57%
Merit Medical Systems IncMMSI	XHE +1.55 points	0.07%	1.62%
Insulet CorpPODD	XHE +1.54 points	0.13%	1.67%
iRadimed CorpIRMD	XHE +1.54 points	<0.01%	1.55%
ICU Medical IncICUI	XHE +1.53 points	0.05%	1.58%
Neogen CorpNEOG	XHE +1.52 points	0.04%	1.56%
Pulse Biosciences IncPLSE	XHE +1.51 points	0.01%	1.52%
Butterfly Network IncBFLY	XHE +1.50 points	0.02%	1.52%
Teleflex IncTFX	XHE +1.50 points	0.08%	1.58%
LivaNova PLCLIVN	XHE +1.50 points	0.06%	1.56%
Procept Biorobotics CorpPRCT	XHE +1.47 points	0.01%	1.48%
Integer Holdings CorpITGR	XHE +1.46 points	0.06%	1.52%
CONMED CorpCNMD	XHE +1.45 points	0.02%	1.47%
Lantheus Holdings IncLNTH	XHE +1.42 points	0.09%	1.51%
Artivion IncAORT	XHE +1.40 points	0.01%	1.41%
Align Technology IncALGN	XHE +1.38 points	0.14%	1.52%
GE HealthCare Technologies IncGEHC	XHE +1.35 points	0.42%	1.77%
Penumbra IncPEN	XHE +1.35 points	0.17%	1.52%
Envista Holdings CorpNVST	XHE +1.36 points	0.05%	1.41%
Steris PLCSTE	XHE +1.34 points	0.29%	1.63%
DENTSPLY SIRONA IncXRAY	XHE +1.34 points	0.02%	1.36%
Zimmer Biomet Holdings IncZBH	XHE +1.32 points	0.24%	1.56%
SI-BONE IncSIBN	XHE +1.30 points	0.01%	1.31%
ResMed IncRMD	XHE +1.29 points	0.45%	1.74%
Baxter International IncBAX	XHE +1.29 points	0.17%	1.46%
Cooper Cos Inc/TheCOO	XHE +1.29 points	0.15%	1.44%
Novocure LtdNVCR	XHE +1.25 points	0.02%	1.27%
Kestra Medical Technologies LtdKMTS	XHE +1.24 points	<0.01%	1.25%
Medline IncMDLN	XHE +1.24 points	0.18%	1.42%
Solventum CorpSOLV	XHE +1.22 points	0.18%	1.40%
Integra LifeSciences Holdings CorpIART	XHE +1.17 points	0.02%	1.19%
Bioventus IncBVS	XHE +1.14 points	<0.01%	1.15%
TransMedics Group IncTMDX	XHE +1.14 points	0.04%	1.18%
IDEXX Laboratories IncIDXX	XHE +1.11 points	0.58%	1.69%
Ceribell IncCBLL	XHE +1.00 points	<0.01%	1.01%
Becton Dickinson & CoBDX	XHE +0.98 points	0.69%	1.67%
Dexcom IncDXCM	XHE +0.97 points	0.47%	1.44%
Edwards Lifesciences CorpEW	XHE +0.97 points	0.69%	1.66%
Cerus CorpCERS	XHE +0.92 points	<0.01%	0.93%
Tactile Systems Technology IncTCMD	XHE +0.91 points	<0.01%	0.92%
Abbott LaboratoriesABT	VHT +0.91 points	2.41%	1.50%
OrthoPediatrics CorpKIDS	XHE +0.62 points	<0.01%	0.63%
Varex Imaging CorpVREX	XHE +0.57 points	0.01%	0.58%
Orthofix Medical IncOFIX	XHE +0.54 points	<0.01%	0.54%
AngioDynamics IncANGO	XHE +0.53 points	<0.01%	0.54%
Boston Scientific CorpBSX	XHE +0.53 points	0.91%	1.44%
Stryker CorpSYK	XHE +0.38 points	1.33%	1.71%
Intuitive Surgical IncISRG	VHT +0.09 points	2.01%	1.92%
Medtronic PLCMDT	XHE +0.06 points	1.54%	1.60%

All 411 VHT holdings⁠All 73 XHE holdings⁠

How we measure overlap

Each holding counts at its smaller weight in the two funds, summed over the full Holdings. Sector, country and asset class use the same rule on each fund’s split. Cash, FX and derivative lines stay out of the counts. Two bond funds get no overlap figure.

VHT vs XHE Cost

Overpaying XHE vs VHT

$5,228

On $10,000 over 30 years. 7% growth a year before fees, expense ratio only.

VHT 0.09%
$1,898
XHE 0.35%
$7,126

Amount$10,000

Years30 years

Cost over time

VHT 0.09%
XHE 0.35%
Overpaying

Year by year

Year	VHT	XHE	Overpaying
10	$165	$634	$469
20	$646	$2,454	$1,808
30	$1,898	$7,126	$5,228

Expense ratio

0.09%VHT, cheaper
0.35%XHE

VHT0.09%XHE0.35%

0.08%0.85%

Middle half of Health Care (Broad) funds
Median 0.50%

VHT 3rd cheapest of 25 funds

XHE 5th cheapest of 25 funds

VHT vs XHE Dividends

Last 12 months to Oct 30, 2026

Yield (12M): VHT 1.35%, better; XHE 0.02%
Payout (12M): VHT $4.61; XHE $0.02
Last payment: VHT $0.97; XHE $0.02
Ex-dividend: VHT Sep 23, 2026; XHE Dec 22, 2025
Paid on: VHT Sep 25, 2026; XHE Dec 24, 2025
Frequency: VHT Quarterly; XHE Quarterly

Distribution history

Per share, 2017 to 2026, same scale for both

VHTQuarterly · 39 paymentsAll VHT payments⁠

XHEQuarterly · 18 paymentsAll XHE payments⁠

VHT vs XHE Risk

Fall from peak · 5 years

Risk facts

VolatilityStd dev, 3 years: VHT 14.5%, betterXHE 19.6%
Return per unit of riskSharpe ratio, 3 years: VHT 0.83, betterXHE 0.37
Worst fallMax drawdown, 5 years: VHT −17.7%, betterXHE −49.4%
Market sensitivityBeta, 5 years: VHT 0.59XHE 1.20; Market = 1

VHT and XHE in the news

All news⁠

Deep Dive
Health care ETFs spent 2026 between a 28% biotech rally and a 16% device slide
Sep 14, 2026VHTXHE
Category Review
Health care funds trail the S&P 500 this year
Updated Oct 7, 2026VHT
Deep Dive
Eli Lilly is 15% of the biggest health care ETF
Sep 25, 2026VHT

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VHT vs XHE

In short

Stated mandate

Why people hold it

Worth knowing

How VHT and XHE differ

Level by level

Sector

Country, concentration and asset class

Country by domicile

Concentration

Asset class

Holdings

Only in VHT

Only in XHE

Weight gaps

Cost over time

Year by year

Distribution history

Fall from peak · 5 years

Risk facts

Health care ETFs spent 2026 between a 28% biotech rally and a 16% device slide

Health care funds trail the S&P 500 this year

Eli Lilly is 15% of the biggest health care ETF

How VHT and XHE differ

Level by level

Sector

Country, concentration and asset class

Country by domicile

Concentration

Asset class

Holdings

Only in VHT

Only in XHE

Weight gaps